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Clinical studies of photodynamic therapy for malignant brain tumors: facial nerve palsy after temporal fossa photoillumination
Author(s): Paul J. Muller; Brian C. Wilson; Lothar D. Lilge; Abhay Varma; Arjen Bogaards; Tim Fullagar; Robert Fenstermaker; Robert Selker; Judith Abrams
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Paper Abstract

In two randomized prospective studies of brain tumor PDT more than 180 patients have been accrued. At the Toronto site we recognized two patients who developed a lower motor neuron (LMN) facial paralysis in the week following the PDT treatment. In both cases a temporal lobectomy was undertaken and the residual tumor cavity was photo-illuminated. The surface illuminated included the temporal fossa floor, thus potentially exposing the facial nerve to the effect of PDT. The number of frontal, temporal, parietal, and occipital tumors in this cohort was 39, 24, 12 and 4, respectively. Of the 24 temporal tumors 18 were randomized to Photofrin-PDT. Of these 18 a temporal lobectomy was carried out exposing the middle fossa floor as part of the tumor resection. In two of the 10 patients where the lobectomy was carried out and the fossa floor was exposed to light there occurred a postoperative facial palsy. Both patients recovered facial nerve function in 6 and 12 weeks, respectively. 46 J/cm2 were used in the former and 130 J/cm2 in the latter. We did not encounter a single post-operative LMN facial plasy in the 101 phase 2 patients treated with Photofrin-PDT. Among 688 supratentorial brain tumor operations in the last decade involving all pathologies and all locations no case of early post-operative LMN facial palsy was identified in the absence of PDT. One further patient who had a with post-PDT facial palsy was identified at the Denver site. Although it is possible that these patients had incidental Bell's palsy, we now recommend shielding the temporal fossa floor during PDT.

Paper Details

Date Published: 13 June 2003
PDF: 7 pages
Proc. SPIE 4952, Optical Methods for Tumor Treatment and Detection: Mechanisms and Techniques in Photodynamic Therapy XII, (13 June 2003); doi: 10.1117/12.479428
Show Author Affiliations
Paul J. Muller, St. Michael's Hospital (Canada)
Princess Margaret Hospital (Canada)
Univ. of Toronto (Canada)
Brian C. Wilson, St. Michael's Hospital (Canada)
Princess Margaret Hospital (Canada)
Univ. of Toronto (Canada)
Lothar D. Lilge, St. Michael's Hospital (Canada)
Princess Margaret Hospital (Canada)
Univ. of Toronto (Canada)
Abhay Varma, St. Michael's Hospital (Canada)
Princess Margaret Hospital (Canada)
Univ. of Toronto (Canada)
Arjen Bogaards, St. Michael's Hospital (Canada)
Princess Margaret Hospital (Canada)
Univ. of Toronto (Canada)
Tim Fullagar, Swedish Medical Ctr. (United States)
Robert Fenstermaker, Roswell Park Cancer Institute (United States)
Robert Selker, Western Pennsylvania Hospital (United States)
Judith Abrams, B.A. Karmanos Cancer Institute (United States)


Published in SPIE Proceedings Vol. 4952:
Optical Methods for Tumor Treatment and Detection: Mechanisms and Techniques in Photodynamic Therapy XII
David Kessel, Editor(s)

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