Integral Photodynamic Therapy of Superficial Bladder Tumors with Special Reference to Carcinoma in Situ

Abstract

Whole bladder wall photodynamic therapy using hematoporphyrin derivative and argon-dye laser light 630 nm was performed on 40 patients with mainly carcinoma In situ of the bladder. Two types of laser light scattering diffuser developed at our department were used: motor-driven and endoscope-modified laser light scattering diffusers. The total energy density used was 10 to 30 Joules/cm². Of the 40 patients, 27 (67.5%) achieved complete response and 5 (12.5%) partial response at 3-months follow-up.

In 11 of the 27 patients, there was no recurrence with an average tumor-free time of 26.3±26.1 months ranging from 3 to 75 months. Bladder capacity was reduced to approximately 150 ml for 3 months after treatment without any evidence of hydronephrosis on excretory urograms, except for 2 patients who had contracted bladders before treatment. The suitability of sulphonated AICI phthalocyanine, a new photosensitizer to replace HpD, is discussed.

Key words:

• Bladder tumors
• Carcinoma in situ
• Integral whole bladder wall photodynamic therapy
• Hematoporphyrin derivative
• Sulphonated AlCl phthalocyanine