Share Email Print
cover

Proceedings Paper

Clinical studies of photodynamic therapy for malignant brain tumors: Karnofsky score and neurological score in patients with recurrent gloms treated with Photofrin PDT
Author(s): Paul J. Muller; Brian C. Wilson; Lothar D. Lilge; Victor X.D. Yang; Abhay Varma; Arjen Bogaards; Fred W. Hetzel; Qun Chen; Tim Fullagar; Robert Fenstermaker; Robert Selker; Judith Abrams
Format Member Price Non-Member Price
PDF $14.40 $18.00
cover GOOD NEWS! Your organization subscribes to the SPIE Digital Library. You may be able to download this paper for free. Check Access

Paper Abstract

In our previous phase II studies we treated 112 patients with malignant brain tumors with 2-mg/kg Photofrin i.v. and intra-operative cavitary PDT. We concluded that PDT was safe in patients with newly diagnosed or recurrent supratentorial malignant gliomas. Pathology, performance grade and light dose were significantly related to survival time. In selected patients when an adequate light dose was used survival time improved. The surgical mortality rate was less than 3%. [spie 2000] We have initiated two randomized prospective trials - the first, to determine if the addition of PDT to standard therapy [surgery, radiation and/or chemotherapy] prolongs the survival of patients with newly diagnosed malignant astrocytic tumors; and the second, to determine whether high light dose PDT [120 J/cm2] is superior to low light dose PDT [40 J/cm2] in patients with recurrent malignant astrocytic tumors. To date, 158 patients have been recruited - 72 to the newly diagnosed malignant glioma study and 86 to the recurrent glioma study. In the recurrent glioma study we compared the pre-operative KS and elements of the neurological examination [speech function, visual fields, cognitive function, sensory examination and gait] to the post-operative examinations at hospital discharge. The means were compared by paired student-t test. The KS in 86 of 88 patients with recurrent gliomas were assessable. The mean [s.d.] preoperative and post-operative KS were 82+/- 14 and 79+/- 17, respectively [p=0.003]. The mean decline in KS, although statistically significant, was small and of no clinical importance. The median Karnofsky score changed from 90 to 80. The KS improved in 8 patients; their post-operative average length of stay (alos) was =9.7 days. There was no change in 47 [alos=8.3], a decline of 10 points in 24 [aloc=13.4] and declined by more than 10 points in 7 [alos=23.3]. Three of these 7 patients who had a decline of >10 points improved in follow-up but did not reach their preoperative KS. The data were not available in 2. Elements of the preoperative and discharge neurological examination were assigned a score and compared by a paired t-test. There was a statistically insignificant improvement in the neurological score. A small but statistically significant decline in Karnofsky score was identified post-operatively in these recurrent tumor patients. Their hospital average length of stay increased with declining Karnofsky score. These prospective clinical observations confirmed our previous conclusion that brain tumor PDT was safe. The clinical studies are supported in part by grant CA 43892 awarded by DHHS/NIH/NCI.

Paper Details

Date Published: 6 June 2002
PDF: 8 pages
Proc. SPIE 4612, Optical Methods for Tumor Treatment and Detection: Mechanisms and Techniques in Photodynamic Therapy XI, (6 June 2002); doi: 10.1117/12.469353
Show Author Affiliations
Paul J. Muller, St. Michael's Hospital and Princess Margaret Hospital/Univ. of Toronto (Canada)
Brian C. Wilson, St. Michael's Hospital and Princess Margaret Hospital/Univ. of Toronto (Canada)
Lothar D. Lilge, St. Michael's Hospital and Princess Margaret Hospital/Univ. of Toronto (Canada)
Victor X.D. Yang, St. Michael's Hospital and Princess Margaret Hospital/Univ. of Toronto (Canada)
Abhay Varma, St. Michael's Hospital and Princess Margaret Hospital/Univ. of Toronto (Canada)
Arjen Bogaards, St. Michael's Hospital and Princess Margaret Hospital/Univ. of Toronto (Canada)
Fred W. Hetzel, Swedish Medical Ctr. (United States)
Qun Chen, Swedish Medical Ctr. (United States)
Tim Fullagar, Swedish Medical Ctr. (United States)
Robert Fenstermaker, Roswell Park Cancer Institute (United States)
Robert Selker, Western Pennsylvania Hospital (United States)
Judith Abrams, Karmanos Cancer Ctr. (United States)


Published in SPIE Proceedings Vol. 4612:
Optical Methods for Tumor Treatment and Detection: Mechanisms and Techniques in Photodynamic Therapy XI
Thomas J. Dougherty, Editor(s)

© SPIE. Terms of Use
Back to Top