Photo Dynamic Therapy (PDT) + Laser Therapy (Diode or Low Level Laser Blood Irradiation) combined, proven to be very effective in cancer treatment and management together with other healing modalities. We have previously discussed the Laser Therapy, but what is PDT?
PHOTODYNAMIC THERAPY
A widely used method of photodynamic therapy using a photosensitizer (PS ) of the second generation of chlorine e6 “Photoditazine " in cancer and non-cancer patients.
Photodynamic therapy ( PDT) - a fundamentally new method for the treatment of malignant tumors, significantly expanding the capabilities of modern oncology and treatment of a number of non-neoplastic diseases. In clinical medicine, the method used with the 1992 and 2002 with one of the standards in oncology . The basis of photodynamic therapy is photodynamic reaction in the growing biological tissues after administration of exogenous photosensitizer (PS ) under certain dose of light energy. Administering to the patient FS concentrated in the tumor. Light radiation of a specific wavelength corresponding to the type of absorption FS at local influence on the tumor induces the formation singlentnogo oxygen and oxygen free radicals, which are toxic to cancer cells and lead to their death. The tumor undergoes necrosis , exfoliates and replaced by normal connective tissue. Recovery occurs . No other harmful to the body in the process of PDT agents is formed. Therefore, photodynamic therapy may be applied before, after and during radiotherapy and chemotherapy , as well as before and after surgery in various combinations with these traditional PDT treatments
Photodynamic therapy may be applied both in the initial stages of cancer as an alternative to surgical treatment, calculated on the total destruction of the tumor , and with the palliation in advanced process to improve the quality of life of incurable patients. PDT is used and in terms of preoperative tumor to convert inoperable patients operable in order to reduce the amount of resection of the affected organ , with the aim of hemostatic tumors , complicated by bleeding , etc. One of the damaging mechanisms of PDT is thrombosis of tumor vessels . High selectivity ( specificity) introduced PS accumulation , the limited depth of cytotoxic effects , the absence of severe local and systemic complications of treatment, the possibility of multiple repeat treatment sessions , combined in one procedure of therapeutic effects and fluorescence diagnosis of tumor boundaries , PDT is well tolerated by elderly patients with severe comorbidities . The ability to use outpatient favorably to traditional methods of PDT treatment of malignant tumors ( surgery , radiation and chemotherapy ) . The selective destruction of the tumor during PDT with maximum preservation of healthy tissue is of particular importance in the so-called localization of tumor foci uncomfortable when surgery is not feasible due to anatomical features. These localizations include skin of the nose , eyelids and periorbital area, the ears , the ear canal , the genitals .
In addition to the classical procedure of PDT is the use of topical PDT in non-cancer patients. This so-called systemic photodynamic therapy . The reason for this procedure is the selective accumulation of PS tissue changes , which is very important in the treatment of diseases with high proliferative activity , such as endometriosis , psoriasis , etc., when traditional treatments do not bring the desired results. A particularly effective method for atherosclerosis large blood vessels for the destruction of atherosclerotic plaques , as well as in the treatment of rheumatoid arthritis.
Much attention deserve particular methods PDT - it photomodifica blood or fotoimmunoterapiya when besides the destruction of tumor cells , inactivation of viruses and bacteria. The method consists in the simultaneous introduction of the blood of FS and its intravenous laser irradiation of the appropriate wavelength . Thus are born the active forms of oxygen , peroxides that destroy cancer cells wherever they may be, that is a fight with metastases . This significantly extends the capabilities of PDT in the treatment of malignancies. So it is the destruction of viruses and bacteria , stimulates the secretion of cytokines - immune protection factors , thus forming antitumor, antiviral, antimicrobial immunity . In addition, cell death leads to a modified signal is applied to the stem cells at the site initiating the formation destroyed new, healthy cells while increasing the level of immune protection of the organism as a whole.
Indications for systemic photodynamic therapy :
- When the initial forms of primary cancer and early recurrence .
- Photodynamic therapy indicated in patients with severe comorbidities and severe age-related changes when traditional methods of treatment ( surgery , radiotherapy ) are contraindicated.
- Combined photodynamic therapy with conventional methods ( surgery, radiotherapy , chemotherapy ) .
- At intradermal metastases to hemostasis , reduce the volume of tumor tissue.
Indications for photodynamic therapy of cancer of skin and mucous:
1. Basal cell, squamous, metatypical cancer (T0N0M0).
- The size of the tumor site can be up to 3 cm in diameter with a thickness (depth)
- Infiltration of not more than 1.0 cm
- Recurrent and residual tumors that are resistant to conventional therapies.
- Multiple foci.
- Extensive damage.
- "Inconvenient" localization for surgical treatment (periorbital area, skate wings and nose, nasolabial folds, pinna, external auditory meatus).
- High risk of complications after radiotherapy and surgery in the treatment of somatic burdened patients.
- Failure of patients to conventional treatment methods. Of photodynamic therapy in gynecology (disease of the vulva )
- Basal cell , squamous , metatypical cancer (T1 - 3N0M0 ) , the size of the tumor site can be up to 3 cm in diameter with a thickness (depth) of infiltration of no more than 1.0 cm
- Recurrent and residual tumors that are resistant to conventional therapies.
- Multiple foci .
- Extensive damage .
- "Inconvenient" localization for surgical treatment.
- High risk of complications after radiotherapy and surgery in the treatment of somatic burdened patients.
- Failure of patients to conventional treatment methods.
- Atrophic and hypertrophic vulvar dystrophy .
Indications for PDT nonmalignant diseases :
1. in psoriasis :
- Progressive and stationary stages of the disease.
- Resistance of the disease to the classical methods of treatment.
- Continuously
- Recurrent disease.
- Severe forms of the disease ( psoriatic arthropathy , psoriatic erythroderma , a large area of skin lesions ) .
- Intolerant drugs.
- Failure of patients to conventional treatment methods.
2 . in acne :
- Acne vulgaris different location and severity .
3 . with nonhealing wounds and trophic ulcers :
- Treatment of wounds in patients with diabetes mellitus type II , burn wounds ;
- The preparation of wounds to autodermoplasty ;
- Trophic ulcers of various etiologies ;
Photodynamic therapy in otolaryngology when treating inflammatory conditions
Currently, there are more reports of the use of PDT in the treatment of non-neoplastic diseases. Based on the numerous studies revealed fungicidal and bactericidal effect of PDT on the majority of microorganisms which cause lung diseases including ENT - organs. Numerous studies have suggested two major mechanisms of photodynamic damage that leads to the destruction of bacteria . The first mechanism is damaged, DNA damage comprising a second cytoplasmic membrane. Despite the fact that photodynamic antimicrobial effect in vitro is known and studied for almost a century , the use of this method for treating bacterial infections in experimental models in clinical practice in the initial stage of research.
Introduced many works , which show the feasibility of photodynamic therapy in the clinical setting for the treatment of a variety of inflammatory processes. So were successfully used intraoral PDT for the treatment of skin infections , also shows the effectiveness of photodynamic treatment in treatment of chronic suppurative diseases of soft tissues. PDT has antibacterial properties. Even relatively mild conventional PDT laser intensity , the concentration of bacteria decreases by three orders of magnitude within 10 minutes.
Positive results were obtained not only in PDT against common pathogens purulent infection but also against anaerobic bacteria and fungi.
Good results in the treatment of purulent sinusitis .
Thus, now have developed all preconditions to talk about the appearance of an entirely new method of treatment of various inflammatory and suppurative disease , fundamentally different from the traditional methods of antibiotic therapy on the following:
- PDT effectiveness does not depend on the sensitivity spectrum of pathogens to antibiotics;
- The development of microbial resistance to the action of PDT is practically impossible, since photodynamic damage caused singlentnogo cytotoxic oxygen free radicals ;
- Photosensitizers (PS ) is not mutagenic , which nullifies selection fotorezistentnyh strains of micro-organisms;
- Antimicrobial effects of photodynamic therapy does not decrease with time during long-term treatment of chronic , localized infection processes .
On any factors PDT shows no systemic antibacterial action or other damaging effects. This refers to the properties of FS and low-intensity laser radiation - the bactericidal effect of PDT is local , but has no harmful effect on the system saprophytic microflora of the body.
Current knowledge suggests that photodynamic damage is local , and bactericidal action is limited to a zone of light exposure. Currently, PDT in otolaryngology has been successfully used for the treatment of chronic tonsillitis and its complications , chronic pharyngitis , rhinitis , sinus congestion, chronic otitis media .The basic conditions for treatment - is the presence of a photosensitizer and a necessary dose radiation exposure.
PDT + Laser Therapy available at:
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