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Proceedings Paper

Photodynamic therapy as a local therapeutic adjunct for the treatment of vertebral metastases
Author(s): Albert Yee; Shane Burch; Margarete Akens; Emily Won; Victor Lo; Lisa Wise-Milestone; Stuart Bisland; Aimee Theriault; Carolyn Niu; Brian C. Wilson; Cari Whyne
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Paper Abstract

Metastatic cancer causes the majority of tumors in bone, most frequently detected in the spinal column. Skeletal complications cause pain and neurologic impairment. Photodynamic therapy (PDT) has been used to treat a variety of cancers. Minimally invasive surgical (MIS) strategies may allow targeted light application essential for PDT within bone structures. The purpose of this manuscript is to provide an update on pre-clinical status as well as early clinical experience of a Phase I clinical trial on vertebral PDT.

A pre-clinical (rnu/rnu rat) vertebral metastasis model of osteolytic (MT-1 breast cancer) was optimized and used to evaluate the effect of vertebral PDT. PDT alone and in combination with other standard local (radiation therapy, RT) and systemic (bisphosphonates, BP) therapies was evaluated through bioluminescence imaging, micro-CT based stereology, histology, and biomechanical testing. Single PDT treatment (photosensitizer BPD-MA, 690nm light) ablated tumor tissue in targeted vertebrae. PDT led to significant increases in bone structural properties, with greatest benefits observed from combined BP+PDT therapy: 76% and 19% increases in bone volume fraction in treated tumor-bearing and healthy untreated controls, respectively. Similar synergistic improvements (but of lesser magnitude) were found in combined PDT+RT treatments.

The safety and feasibility of MIS+PDT were evaluated in scale-up animal studies, refining surgical technique for clinical translation. Following appropriate institutional review board as well as Health Canada approval, 5 patients (light only control group) have undergone protocoled treatment to date. These patients have guided further refinement of human therapeutic application from a laser delivery and vertebral bone access perspective.

Paper Details

Date Published: 8 March 2013
PDF: 6 pages
Proc. SPIE 8565, Photonic Therapeutics and Diagnostics IX, 85656O (8 March 2013); doi: 10.1117/12.2019796
Show Author Affiliations
Albert Yee, Sunnybrook Health Sciences Ctr. (Canada)
Univ. of Toronto (Canada)
Shane Burch, Univ. of California, San Francisco (United States)
Margarete Akens, Sunnybrook Health Sciences Ctr. (Canada)
Univ. of Toronto (Canada)
Sunnybrook Research Institute (Canada)
Emily Won, Sunnybrook Research Institute (Canada)
Victor Lo, Sunnybrook Research Institute (Canada)
Lisa Wise-Milestone, Sunnybrook Research Institute (Canada)
Stuart Bisland, Ontario Cancer Institute (Canada)
Aimee Theriault, Sunnybrook Health Sciences Ctr. (Canada)
Univ. of Toronto (Canada)
Carolyn Niu, Ontario Cancer Institute (Canada)
Brian C. Wilson, Ontario Cancer Institute (Canada)
Cari Whyne, Sunnybrook Health Sciences Ctr. (Canada)
Univ. of Toronto (Canada)
Sunnybrook Research Institute (Canada)

Published in SPIE Proceedings Vol. 8565:
Photonic Therapeutics and Diagnostics IX
Andreas Mandelis; Brian Jet-Fei Wong; Anita Mahadevan-Jansen; Henry Hirschberg M.D.; Hyun Wook Kang; Nikiforos Kollias; Melissa J. Suter; Kenton W. Gregory M.D.; Guillermo J. Tearney M.D.; Stephen Lam; Bernard Choi; Steen J. Madsen; Bodo E. Knudsen M.D.; E. Duco Jansen; Justus F. Ilgner M.D.; Haishan Zeng; Matthew Brenner; Laura Marcu, Editor(s)

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