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ECU study: PDT beneficial for patients with chest wall tumors
Dr. Rosa Cuenca's research on PDT has been published in Annals of Surgical Oncology. Photo by Cliff Hollis.
GREENVILLE, N.C. (Apr. 7, 2004) — Photodynamic therapy, a relatively new treatment for cancer, shrunk lesions and lessened pain in patients with chest wall tumors arising from breast cancer, according to a research article published by faculty at East Carolina University’s Brody School of Medicine.
Though not a cure, PDT provides an “excellent clinical response” and should be considered as a viable treatment option for these patients, according to Dr. Rosa Cuena, the lead author of the article published in the March edition of the Annals of Surgical Oncology. Cuenca presented the data at last year's Society of Surgical Oncology's Clinical Congress in Los Angles.
In addition to Cuenca, who is an assistant professor of surgery and surgical director of the PDT program, other contributors were Dr. Ron Allison, chairman of the Department of Radiation Oncology and clinical director of the PDT program; Dr. Claudio Sibata, professor of radiation oncology and the PDT program science director; and Dr. Gordon Downie, an interventional pulmonologist at the medical school and medical director of the Photodynamic Therapy Center.
The authors are involved with the photodynamic therapy program at the Leo W. Jenkins Cancer Center, which is jointly supported by Pitt County Memorial Hospital and the Brody School of Medicine.
Photodynamic therapy uses a combination of photosensitizing agents and a specific frequency laser light to kill cancerous tumors. The agents are absorbed by cells all over the body but for unknown reasons stay longer in the cancer cells. When the treated cancer cells are exposed to the laser light a few days after the initial injection, the photosensitizing agent, Photofrin, absorbs the light and produces a form of energy that destroys the treated cancer cells.
In the article, Cuenca documents the results of PDT treatment of more than 500 metastatic lesions in 14 breast cancer patients, aged 38 to 60, between March 2000 and December 2002. All received one PDT treatment with Photofrin; one patient required retreatment because of extensive disease. None of the patients was actively receiving chemotherapy while being evaluated for PDT.
These patients represent a breast cancer population, which has exhausted all other treatment options, Downie said. Cancers growing on the chest wall are usually painful and psychologically depressing to patients and caregivers.
“PDT offers an excellent treatment option to control these concerns, and cosmetic results are superb. Patients come from all over the world to Greenville for this therapy; the program has treated or evaluated more than 200 patients from 22 states and five nations,” Downie said.
Follow-up was documented at six months with several patients followed for more than 24 months. All patients demonstrated death of the tumor cells; however, disease progression was documented outside of the treatment area.
In her discussion section of the research article, Cuenca calls for more surgical oncologists to evaluate PDT as a treatment option for chest wall tumors in breast cancer patients and other tumors. The Leo W. Jenkins Cancer Center's PDT program has treated multiple tumor types, including head and neck, skin, lung and gastrointestinal tumors.
Treatment of esophageal cancer and high-grade dysplasia will soon be available with the addition of Dr. Walter Scott, ECU assistant professor, to the program team. Dr. Brian Brodish of Eastern Carolina ENT-Head & Neck Surgery and Dr. Carter Childs, ECU clinical assistant professor, have also joined the treatment team for added head and neck and pulmonary expertise, respectively.
“PDT offers good local control for many patients, often rapidly contracting and drying the tumor surface and reducing wound care issues,” Cuenca writes. “Outpatient treatment makes this modality more feasible and cost-effective; PDT should be offered to these patients.”
Jeannine Manning Hutson
East Carolina University
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