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Introduction The study of the antibacterial effect of photodynamic therapy against the leading pathogens of chronic osteomyelitis is one of the promising directions today. Purpose of the work was to evaluate the antibacterial effect against the strains of Staphylococcus aureus and Pseudomonas aeruginosa with the ALOD-01 laser system in the presence of photodithazine. Materials and methods The object of the study was 24-hour archival cultures of gram-positive and gram‑negative microorganisms belonging to two taxa: Staphylococcus aureus (25923), Pseudomonas aeruginosa (27853). The antibacterial effect after the exposure to laser radiation in the presence of photodithazine on the microbial cells of the studied cultures was assessed by the absence of microorganism growth in the area of the light beam. Results Laser exposure in combination with photodithazine (concentration 0.5–1.0 mg/ml) on S. aureus for two minutes at 200–300 J achieved a bactericidal effect in the beam area. A bactericidal effect on the entire surface of the Petri dish was achieved with light exposure of 400 J for 5 minutes and a photodithazine concentration of 1.0 mg/ml. Laser exposure for 2 minutes in the presence of photodithazine at a concentration of 0.5 mg/ml and 1 mg/ml did not have an antibacterial effect on P. aeruginosa strains. Continuous growth of microorganisms was observed on the dish. Increasing the light dose and exposure time contributed to a decrease in the growth of microbial cells. A bactericidal effect was obtained only in the center of the dish in treating the bacterial suspension with photodithazine at a concentration of 5 mg/ml. Discussion The effectiveness of PDT depends on the type of microorganisms, the anatomical location of the infection site, as well as the properties of the photosensitizer and the laser used. Depending on the structure of the cell wall, different susceptibility of bacteria to photodynamic effects is observed. Conclusion S. aureus strains can be successfully photoinactivated using photodithazine. For P. aeruginosa strains, it was not possible to find a regime in which microbial cell growth was absent throughout the dish. The photodynamic reaction occurs only when adequate doses of light energy act on the photosentisizer in the presence of oxygen in the medium, while the photodynamic damage is local and the bactericidal effect is limited by the zone of light exposure.

Objectives. To synthesize Pt-containing derivatives of natural chlorins as potential agents for the combination therapy in oncology. Platinum compounds are known to occupy an important place as chemotherapeutic agents in the treatment of oncological diseases. However, Pt(II) complexes are highly toxic to the body and are not selectively accumulated in tumor cells. If photodynamic and chemotherapy methods are combined in a single drug, the pigments are responsible for the selectivity of conjugate accumulation in the tumor, while a chemotherapeutic agent based on Pt(II) complexes is responsible for the cytotoxic effect on tumor cells. This will not affect healthy cells and thereby minimize the systemic toxicity of the drug to the body.Methods. Methods for the synthesis of pyridine-containing derivatives of natural chlorins and their metal complexes for use as potential binary agents in oncology were applied. As part of the study, the structures of the compounds obtained were confirmed by mass spectrometry, nuclear magnetic resonance spectroscopy, ultraviolet spectroscopy, and high-resolution chromatography-mass spectrometry. Preparative methods, including thin-layer and column chromatography, centrifugation and recrystallization, were used to isolate and purify the compounds obtained.Results. Platinum(II) complexes of pyridine-containing derivatives of natural chlorins were obtained for application in combination therapy in oncology. The schemes for synthesizing the target photosensitizers were optimized, in order to increase the yields and for subsequent transfer to industrial sites.Conclusions. It was found that pyridine-containing derivatives of natural chlorins could be obtained in high yields, that they possess chelating properties for platinum, and can be considered as binary agents in cancer therapy after successful preclinical trials.

The aim of the study was to present various types of radiation that can increase the effectiveness of combined photodynamic therapy (PDT) for malignant and premalignant lesions. Material and Methods. The Web of Science, Scopus, MedLine, Library, and RSCI databases were used for finding publications on this topic, mainly over the last 10 years. Of 230 sources, 64 were included in the review. Results. Photodynamic therapy is a new cancer treatment technology that has become increasingly popular in recent years. It is often an alternative method of treating cancer when there is a high risk of side effects and complications during traditional treatments such as surgery, radiation therapy and chemotherapy. PDT requires a photosensitizer, light energy, and oxygen to create reactive oxygen species that destroy cancer cells. This review examines the basic principles and mechanisms of PDT used alone and in combination with other traditional therapies. Despite the fact that PDT is an effective and non-invasive cancer treatment, it has some limitations, such as low light penetration depth, ineffective photosensitizers and tumor hypoxia. Our study examines new strategies that use other energy sources, such as infrared- and x-rays, ultrasound, as well as electric and magnetic fields, to enhance the PDT effect and overcome its limitations. Great hopes are also associated with the use of a combination of PDT and neutron capture therapy (NСT). Currently, chlorin derivatives associated with boron carriers have been developed. They can be used for both fluorescence diagnostics and PDT, as well as for NСT. The synthesized compounds have a high selectivity of accumulation in the tumor. To date, encouraging preclinical results of high efficiency of combined use of NСT and PDT have already been obtained. Conclusion. Combination with various energy sources is a key factor for further development of PDT. Future research aimed at overcoming the limitations of PDT will contribute to unlocking the full potential of this technology in clinical practice.

A systematic review and meta-analysis was aimed to assess the effectiveness of palliative photodynamic therapy for unresectable malignant tumors of the biliary system in order to justify the feasibility of including photodynamic therapy (PDT) in the complex treatment of this category of patients. Publications in the databases PubMed Central, the bibliographic database of scientifi citations of the RSCI, and the Cochrane library were considered. Heterogeneity was assessed graphically using forest plots and statistically using tau2 and I2 statistics. A meta-analysis of 5-year survival revealed a statistically signifiantly longer pooled estimate of the survival period in groups where PDT was used – 339±161 days (95% CI 25-710; p < 0.001) compared to groups where PDT was not used – 83±16 days (95% CI 33-100; p < 0.001). Heterogeneity among studies was found to be statistically insignifiant (I2 = 29%, p = 0.23). A meta-analysis of the risk difference for adverse events revealed a statistically signifiantly lower risk (-0.2306; 95% CI -0.3917-0.0696; p = 0.005) of adverse events after PDT compared with the comparison group. Heterogeneity among studies was found to be statistically insignifiant (I2 = 0%, p = 0.35). There were no signifiant publication biases in either meta-analysis. The presented meta-analysis demonstrated that PDT may be the method of choice in the palliative complex treatment of patients with unresectable cholangicarcinomas, increasing the ˝ve-year survival of patients along with the absence of increased risks of postoperative complications in comparison with other methods of palliative surgical treatment.

Hypoxia negatively affcts the effctiveness of all types of anticancer therapy, in particular photodynamic therapy (PDT). In this regard, various approaches to overcome the limitations associated with hypoxia are widely discussed in the literature, one of them is the use of photosensitizers (PS) operating through the fist mechanism of the photodynamic reaction, such as methylene blue (MB). Previously, we have demonstrated that MB can have a positive effect on tumor oxygenation. In this work, we investigated the photodynamic activity of MB and a combination of MB with chlorin e6 on a tumor in vivo using a model of Ehrlich carcinoma. PDT was studied with the joint and separate administration of chlorin e6 and MB. The accumulation and localization of MB and its combination with chlorin e6 in vivo was assessed using video ˛uorescence and spectroscopic methods, and the effect of laser exposure on accumulation was analyzed. After the PDT with chlorin e6, MB and a combination of MB with chlorin e6, a good therapeutic effect and a decrease in the tumor growth rate were observed compared to the control, especially in groups with PDT with MB and with the simultaneous administration of chlorin e6 and MB. The level of tumor oxygenation on days 3 and 5 after PDT was higher for groups with irradiation, the highest oxygenation on the 5th day after PDT was observed in the group with PDT only with MB. Phasor diagrams of tumors after PDT show a deviation from the metabolic trajectory and a shift towards a longer lifetimes compared to the control tumor, which indicates the presence of lipid peroxidation products. Thus, tumor regression after PDT is associated with the direct destruction of tumor cells under the in˛uence of reactive oxygen species formed during PDT. Thus, the effectiveness of PDT with the combined use of MB and chlorin e6 has been demonstrated, and the main mechanisms of the antitumor effect of the combination of these PS have been studied.

Features of the expression of membrane importers of 5-ALA, as well as transporters involved in the removal of photoactive precursors of protoporphyrin IX (PPIX) (uro-, copro- and protoporphyrinogens), may cause differences in the effectiveness of photodynamic therapy of malignant neoplasms using 5-aminolevulinic acid (5-ALA). Increased expression of ALA transporters is associated with an increase in the intensity of PPIX synthesis. When the expression of PPIX exporters increases, there is a decrease in PPIX concentration. The review describes the main transporters of 5-ALA, uro-, copro- and protoporphyrinogens, provides data on their expression in various tissues, and discusses the possibility of predicting the effectiveness of photodynamic therapy considering the expression of the corresponding transport proteins in malignant tissues.

In this work, we studied the development of tolerance to low-intensity violet (405 nm, 80 mW/cm2 , 72 J/cm2 ) LED radiation in a clinical antibiotic-resistant strain of Staphylococcus aureus 2a. The change in numbers during 20 cycles of irradiation was studied, the reaction of bacterial cells to oxidative stress was studied – sensitivity to the presence of hydrogen peroxide in the environment and catalase activity. It was shown hat from cycles 1 to 5 there was a signifi cantly insignifi cant reduction in survival rate – from 85% to 82%, from cycles 5 to 10 of irradiation the decrease in the number of cells became more pronounced – from 82 to 63%, then, from cycles 10 to 15, recovery was noted, showing numbers to higher values (65–76%), from cycle 15 to 20, the survival value after irradiation remained at the same level (80%). It has been established that, starting from the 15th irradiation cycle, the culture becomes 2 times more resistant to the action of oxidative factors. The results obtained showed that the use of the photodynamic therapy method in practice must be approached with caution, since the formation of tolerance to the eff ects in the tagret microorganism occurs by the 15th irradiation cycle and can signifi cantly worsen the treatment results.

The aim of this study was to analyze the immediate and long-term results of using photodynamic therapy (PDT) in patients with leukoplakia of the oral mucosa. The retrospective study included 223 patients with morphologically verified leukoplakia of the oral mucosa. Patients received treatment at the hyperthermia and photodynamic therapy department from 2013 to 2023. The average age was 51.9±8.9 years. Clinically, 211 patients (94.6%) had a flat form of the disease, 12 patients (5.4%) had a verrucous form. The photosensitizer (PS), based on chlorin e6, was administered intravenously once in doses of 1.7 to 2.5 mg/kg body weight. Irradiation of pathologically changed lesions was carried out 2-2.5 hours after the end of its infusion, using a semiconductor laser device “UPL PDT”, with a wavelength λ=665±5 nm. The laser radiation dose density varied from 25 to 100 J/cm², the power density from 0.07 to 0.32 W/cm², the duration of one irradiation field - from 2 to 13.5 minutes, depending on its linear dimensions. The severity of adverse reactions was assessed on days 1-30 after treatment using the CTCAE 4.03 scale. The immediate results of treatment were assessed up to 3 months after PDT, with morphological confirmation of the response to treatment. No serious adverse reactions were observed during PS infusion and irradiation. No symptoms of dermal phototoxicity were reported. During control examinations, up to 3 months after irradiation in patients with flat and verrucous forms, the frequency of complete regressions was 97.1% (n=205) and 58.3% (n=6) cases, partial regressions - 2,9% (n=7) and 25% (n=3) of cases, respectively. Objective response rates were observed at 100% and 83.3%, respectively. The period of observation of patients varies from 3 to 120 months. (average 66 months). The frequency of disease relapses during this period was 9%. Patients with partial regression and identified relapse were treated with repeated PDT sessions. PDT is a well-tolerated and effective treatment method for patients with leukoplakia of the oral mucosa, which has significant advantages over traditional methods of treating this precancerous pathology. These include minimal toxicity to the normal tissues surrounding the pathological foci due to the selective accumulation of PS in leukoplakia tissues, a slight risk of serious adverse reactions, the possibility of an outpatient session, the possibility of repeated treatment over a large area of damage and good cosmetic results).

Photodynamic therapy is an effective method for treating superficial forms of malignant neoplasms, characterized by a minimal risk of damage to normal tissues. In this study, we presented our experience of treating cancer of the oral mucosa using photodynamic therapy, and analyzed the immediate and long-term results of treatment. 38 patients with squamous cell carcinoma of oral cavity mucosa, with a depth of invasion no more than 7 mm, were included in the study. All patients underwent photodynamic therapy with chlorine e6 based photosensitizer. Photosensitizers were administered intravenously 3 hours before irradiation, at a dosage of 1 mg/kg of the patient’s weight. Photodynamic therapy was performed with the following parameters: P – 1.0 W, Ps – 0.31 W/cm2, E – 300 J/cm2. The area of one irradiation field ranged 1.0-2.0 cm2. Treatment effect was evaluated by RECIST 1.1. Overall survival, cancer-specific survival, and disease-free survival were calculated using Kaplan-Meier curves. Evaluation of adverse events was made by .TCAE 5.0 criteria. At 35 (92.1%) out of 38 cases, complete regression was observed after photodynamic therapy. Among them in 3 out of 35 patients relapse was diagnosed in 11.5 to 43.2 months. The total number of patients who didn’t respond to treatment was 6 (15.8%). Follow-up period was 4.2-87.3 months. (mean 42.9). 34 (89.5%) out of 38 patients are alive, 1 (2.6%) died from progression, and three died from other causes. The 5-year overall survival rate was 82.1%, cancer-specific survival rate was 97.0%, and disease-free survival rate was 81.1%. Among the factors significantly (p < 0.05) influencing relapse-free survival: depth of invasion < 5 mm (p – 0.013) and the presence of leukoplakia (p – 0.007). When assessing cancer-specific survival, factors worsening the prognosis were: age >70 years (p – 0.034) and the presence of leukoplakia (p – 0.007). Photodynamic therapy is an alternative treatment method of oral cancer superficial lesions, in case of proper assessment of primary lesion and in case of possibility of full irradiation of the tumor. Moreover, after using photodynamic therapy, the underlying connective-muscular structures are preserved, which promotes rapid healing with minimal scarring, the functions of the affected organ remain intact, and cosmetic defects do not form.

Objective: to demonstrate the first long-term outcomes of treatment of unresectable hilar cholangiocarcinoma (HCCA) after combined neoadjuvant therapy followed by liver transplantation (LT). Materials and methods. From 2017 to 2023, at the Russian Research Center of Radiology and Surgical Technologies, 10 patients were included in the treatment protocol for unresectable HCCA. Combined neoadjuvant therapy included endobiliary photodynamic therapy (EPDT), regional chemotherapy (RCT) and systemic polychemotherapy (SPCT). Each modality was applied at least three times over a period of four to six months. Patients were placed on the LT waitlist when tumor marker CA19-9 reduced, there was no radiological evidence of disease progression, and there was no evidence of acute cholangitis. Before LT, the recipients underwent diagnostic laparoscopy to exclude carcinomatosis and also evaluation of regional lymph nodes with urgent morphologic examination. In the absence of extrahepatic tumor spread, LT from a deceased donor was performed according to the classical technique with paracaval and hepatoduodenal lymph node dissection, biliodigestive anastomosis using the Roux-en-Y procedure. The operation was performed in six patients. Patient age ranged from 40 to 55 years (mean, 46.3). The mean time from start of treatment to LT was 9.1 months (range 6 to 14). The mean CA19-9 level at the time of LT was 66.5 IU/mL (8 to 212). Results. After combined neoadjuvant treatment, the CA19-9 marker normalized in four patients and there was a 3–4-fold decrease in two patients. Radiological evaluation indicated stable disease in five patients, and a partial response in one. Disease progression was noted in four out of 10 patients. Currently, one of the 6 patients is alive with a follow-up of 34 months. Median (Me) overall survival is 28 months; Me overall survival after LT is 22.2 months; Me survival before progression is 27 months. During long-term follow-up of patients after LT, three patients out of six had disease progression: implantation metastasis (n = 2) at 25 and 27 months follow-up (metastasectomy was performed), carcinomatosis (n = 1) at 20 months follow-up. Conclusion. LT for unresectable Klatskin tumor is effective when combined neoadjuvant treatment is used and there is no acute cholangitis. However, the use of endobiliary manipulations (drainage change, EPDT) are risk factors for the development of implantation metastasis.

Introduction. The search for new methods of therapy for non-small cell lung cancer (NSCLC) is an urgent task of modern science. Gefitinib is a targeted drug widely used in the treatment of NSCLC in patients with a mutation in the epidermal growth factor receptor tyrosine kinase domain. However, using of gefitinib and other drugs from the group of tyrosine kinase inhibitors is to limited by rapidly developing resistance, for this reason finding of a ways overcome drug resistance is actual part of research interests.Text. The review is devoted to the use of gefitinib in modern developments: introduction to various targeted delivery systems (liposomes, micelles, microspheres, etc.), studying it in combination with other chemotherapeutic agents, as well as in combination with photo- or thermosensitive compounds in various micro- and nanostructured complexes.Conclusion. As a result of the analysis of literature data, it was shown that, despite the fact that gefitinib is a first-generation drug, foreign and Russian researchers consider it quite promising for further use in the treatment of NSCLC. At the same time, developments are being carried out both in the field of expanding combination therapy and in the field of creating complex structures of targeted action, into which, in addition to gefitinib, photosensitizers or other compounds with photo- or thermosensitive effects are introduced.

Bowen’s disease is a form of non-invasive (in situ) squamous cell skin cancer localized in the non-genital area. Russian and European clinical guidelines include photodynamic therapy (PDT) in the standard of care for patients with Bowen’s disease. In the present review, the efficacy and safety profile of different PDT regimens for Bowen’s disease are analyzed according to the available literature data. PDT can be used to treat large Bowen’s disease lesions localized in areas of the body characterized by severe healing and in cases where surgery is not feasible. Analysis of the results of studies shows that PDT is superior in efficacy and cosmetic results to traditional local treatments such as 5-fluorouracil or cryotherapy. In all analyzed studies in patients with Bowen’s disease, PDT achieved a significant clinical effect. Complete regression of pathologic foci was achieved in 67-100% of patients. In studies evaluating the recurrence rate of Bowen’s disease after PDT, this value ranged from 2-28% with the range of 6-18% in most of the studies. Most often, 5-aminolevulinic acid and its methyl ester are used for PDT in Bowen’s disease. According to some researchers, aminolevulinic acid allows to achieve a more long-term positive clinical effect with a lower incidence of painful reactions during treatment

The article provides an example of successful treatment of a patient with basal cell skin cancer of the lower eyelid of the right eye, stage IB cT2aN0M0, with the presence of concomitant pathology – a decrease in the activity of plasma factor XII of blood coagulation (Hageman disease). The patient’s medical history is associated with long-term ineffective treatment of the tumor with Curaderm ointment. After diagnosis and further examination at the Moscow Research Institute named after. P.A. Herzen, at the Center for Laser and Photodynamic Diagnostics and Therapy of Tumors, the patient underwent organ-preserving treatment using photodynamic therapy. 1 course of photodynamic therapy with the photosensitizer chlorin e6 was carried out. Complete tumor regression was obtained; relapse-free follow-up period was 1 year

The aim of the review is to analyze the latest data on the current state of diagnosis and management of a common benign vulvar and vaginal disease in postmenopausal women – atrophic vulvovaginitis. The paper presents an analysis of national and foreign scientific publications on the diagnosis and management of vulvovaginal atrophy and also focuses on the modern nomenclature and terminology of this pathology. Vulvovaginal atrophy is a common and progressive condition affecting on average more than 50 % of postmenopausal women, and its development and severity depend mainly on the duration of hypoestrogenism. Such a hormonal imbalance with a gradually increasing estrogen deficiency leads to atrophic changes in the tissues of the female genital organs and thinning of the vaginal epithelium. Degenerative alterations are accompanied by inflammatory phenomena and disturbances in the vaginal microflora. Atrophic lesions in the genitourinary system induce urinary incontinence aggravation, dysuria, increased micturition frequency, and recurrent urinary tract infections. Vulvovaginal atrophy is diagnosed based on appropriate clinical assessments as well as with the involvement of validated questionnaires. Differential diagnosis of the vulvovaginal atrophy should include all pathological conditions imitating the clinical symptoms and signs. Experts of the International Society for the Study of Women’s Sexual Health and the North American Society of Menopause have proposed a new nomenclature, namely, the terms “vulvovaginal atrophy” and “atrophic vaginitis” have been supplanted by “genitourinary menopausal syndrome”. First-line therapy for mild symptoms is non-hormonal vulvar and vaginal lubricants, vaginal moisturizers used on a regular basis. Hormonal therapy (both transdermal and oral) remains the most effective choice for the treatment of clinical manifestations, but contraindications to its use should be considered. In women with contraindications to systemic hormonal therapy, it is possible to prescribe estrogens in the form of vaginal suppositories or vaginal cream. 5-Aminolevulinic acid photodynamic therapy can be one of the promising methods in the treatment of this women’s clinical group. Given the serious consequences of vulvovaginal atrophy for the patients’ health and quality of life, timely diagnosis of the disease in accordance with its specificity and possible complications is of primary importance for the successful treatment and management of this pathology. Conclusions. Vulvovaginal atrophy has been shown to be a common disease, especially among women in the postmenopausal period, based on the analysis of national and foreign scientific publications. The pathogenesis of vulvovaginal atrophy is associated with hypoestrogeny which results in structural and functional abnormalities of the genital organs such as mucus thinning, loss of elasticity, changes in microbiota and increased pH. Given the new nomenclature and terminology, it is appropriate to use the term “genitourinary menopausal syndrome” (GMS or GUMS) in lieu of “vulvovaginal atrophy”.

Literature review reflects the current status and development status of intraoperative photodynamic therapy in neurooncology and discusses the results of the most important studies on photodynamic therapy (PDT). We searched the Pubmed, EMBASE, Cochrane Library and eLibrary data-bases for publications published between January 2000 and December 2022. Found 204 publications in foreign sources and 59 publications in domestic editions, dealing with the issues of photodynamic therapy in neurooncology. An analysis of the literature has shown that intraoperative PDT in neurooncology is an important tool that contributes to increasing the radicality of the operation and local control. The basic rationale for the effectiveness of PDT lies in the study of the pathways leading to the complete devitalization of a malignant tumor, the study of the mechanisms of the local and systemic immune response. In addition, subcellular targets in PDT are determined by the properties of photosensitizers (PS). Second generation PSs have already been introduced into clinical practice. The effectiveness of PDT using photoditazine, 5-aminolevulinic acid has been demonstrated. The mechanisms of action and targets of these PS have been established. In Russia, a number of studies have repeatedly shown and proved the clinical effectiveness of PDT in groups of neurooncological patients with glial tumors and secondary metastatic tumors, but so far, the method has not been included in the clinical guidelines for the provision of high-tech neurosurgical care. There is certainly a need for further development of PTD techniques in neurooncology, especially in patients at high risk of recurrence and aggressive CNS tumors.

Colposcopy allows the examiner to localize potential lesions, assess the severity of the lesion, and obtain a colposcopic guided biopsy. This method has limited sensitivity and specificity, raising serious concerns about the possibility of missing cervical dysplasia. Fluorescent methods for diagnosing precancerous diseases of the cervix and early forms of cancer have an extremely high sensitivity, reaching 90%. The presented results of the study allow us to fully declare the high information content of fluorescent colposcopy in identifying dysplastic lesions on the cervix.

This review demonstrates the possibilities of photodynamic therapy in treatment of non-tumor pathologies using dimeglumine chlorin E6 as a photosensitizer. Initially, the method was invented for the treatment of cancer and demonstrated its effectiveness and safety. In present photodynamic therapy successfully used in the treatment of the bronchus, skin, stomach, cervix, larynx cancer. In addition to the treatment of different localization tumors, various studies demonstrated other positive effects of photodynamic therapy: antimicrobial, antimycotic, autoimmune, reparative. In the presented review, dimeglumine chlorin E6, which is a derivative of chlorin e6, acts as a photosensitizer. It demonstrates safety, high selectivity of accumulation in tissues, and is characterized by a short period of excretion from the body. Using of dimeglumine chlorin E6 cans significantly reduce the number of side effects associated with long-term skin phototoxicity.

The aim of the study was to evaluate the effectiveness of modern approaches to the treatment of patients with various types of vulvar intraepithelial neoplasia. Materials and methods. A prospective study of the results of VIN treatment in 262 women aged 25 to 70 years (mean age 51.12±13.41 years) was conducted. Treatment was provided to 155 women with HPV-independent vulvar dysplasia (dVIN), 98 women with severe HPV-independent vulvar dysplasia (VHSIL), and 9 women with grade Ia vulvar Paget's disease. Depending on the type and features of the disease, clinical and morphological characteristics, size, location, age and anamnesis, a particular treatment method was chosen, namely: excision, photodynamic therapy (PDT) with chlorine E6; PDT with 5-aminolevulinic acid; 5% imiquimod cream; vulvectomy (partial/complete). In some cases, a combination of methods was used: excision and 5% imiquimod cream; excision with PDT with 5-aminolevulinic acid. Results. Cream with 5% imiquimod was used in our study mainly in women with VHSIL and showed quite high efficacy in the treatment process. After 3 months, partial regression was registered in 93.75% of cases, after six months, complete regression occurred in 71.87% of patients, and after a year - in 81.25% of women. Morphologically, after 3 months, the recurrence of the disease was registered only in 31.25% of patients, while over time a complete coincidence of clinical and morphological indicators was registered. Combined therapy with imiquimod showed high efficacy both clinically and morphologically with complete regression of the disease (100%) and absence of relapses during the year of follow-up in all patients to whom this approach was used. Treatment with the systemic use of PDT with chlorin E6 showed a complete regression of the pathological focus clinically and morphologically in 96.65% of women after 3 months. The same indicators remained after 6 months, but after a year, the percentage of women with partial regression with morphologically confirmed recurrence slightly increased to 15.08%. Conclusions. Modern methods of conservative treatment of vulvar intraepithelial neoplasia using imiquimod cream and systemic photodynamic therapy can be a highly effective alternative to surgical intervention.

Acne is one of the most common skin conditions in the world. A number of studies have shown that photodynamic therapy (PDT) is safe and effective for both inflammatory and non-inflammatory acne and can significantly improve skin conditions in this disease. The effectiveness of PDT against acne is mainly due to a decrease in the amount of sebum produced by the sebaceous glands due to a decrease in their activity as a result of direct photodynamic damage to the sebaceous glands, eradication of Cutibacterium acnes, and a decrease in the level of hyperkeratosis. Compared with systemic drug therapy, PDT treatment of severe acne has the following advantages: fast results, high efficiency, high selectivity, no systemic adverse reactions and drug resistance, and low recurrence rate. Most often for PDT in patients with acne, drugs based on 5-aminolevulinic acid (5-ALA) and its methyl ester (ME-ALA) are used. At the moment, there are no unified recommendations on PDT regimens for the treatment of this skin pathology. Various studies demonstrate the high efficiency of PDT with a wide range of doses of 5-ALA (3-20%) and ME-ALA (4-16%), light doses (15-120 J/cm2 ), and exposure time (30-90 min). The general trend in studies by different authors is that gentle low-intensity PDT regimens for acne demonstrate the same high efficiency with a significant reduction in pain during irradiation and local skin reactions (erythrema, edema, and hyperpigmentation).

The article presents the results of a study of survival, markers of hemostasis, proteolysis, and tumor invasion after complex palliative treatment of patients with histologically verified malignant tumors of the bile ducts complicated by obstructive jaundice in two comparable groups of patients. The aim of the study was to evaluate the effectiveness of palliative surgical treatment using photodynamic therapy in patients with malignant tumors of the biliary system complicated by obstructive jaundice. In 10 patients of the main group, palliative surgical treatment was performed using photodynamic therapy; in 20 patients of the comparison group, palliative surgical treatment was performed without photodynamic therapy. In patients of the main group, a statistically significant increase in life expectancy by 104 days (p=0.033) was observed compared to the comparison group. At the same time, a statistically significant effect of tumor necrosis factor α, a marker of tumor invasion, on survival (p = 0.012) and a decrease in its level after photodynamic therapy by 15 pg/ml (p=0.041) was revealed. Thus, palliative treatment using photodynamic therapy of malignant tumors of the bile ducts, complicated by obstructive jaundice, can increase the survival rate of patients by reducing tumor invasion.

Background. Healing of open wounds in the oral cavity is often accompanied by infection and constant traumatization, which lead to impaired blood supply to the tissues, lack of trophic support and low oxygen supply to increasing proliferative processes. Recently, photodynamic therapy has taken its place among the methods for stimulating regeneration of oral mucosal tissues. The authors consider it essential to study the influence of photodynamic treatment on the functional state of the microvasculature in the wound tissues, which determines the transcapillary exchange and the tissue respiration, providing the tissue regeneration.Objective. To study the photodynamic effect of sequential dual-wavelength radiation on the microvasculature in the wound tissues of the oral mucosa in vivo.Methods. The study was carried out on 36 female outbred Wistar rats, weighing 200–250 g. The animals were divided into two groups: control group (n = 18) and experimental group (n = 18). Wound surfaces healed by secondary intention were modeled on the cheek mucosa of the animals. Dual-wavelength photodynamic therapy was performed in the 1st postoperative day in experimental group. The microcirculatory function was assessed by Doppler flowmetry before, and on days 3, 7 and 14 after wounding. The results were processed using IBM SPSS Statistics 26.0.0.1 (IBM Inc., USA).Results. It has been established that dual-wavelength photodynamic therapy has a positive effect on the restoration of the microvasculature of the wound tissues. This therapy facilitated bypassing for microcirculatory flow on the 3rd day of the study, and increased the perfusion of tissues on the 7th. The experimental group did not have congestive-ischaemic phenomena in the wound region; the microcirculatory flow was augmented through the microcirculation regulation by the 14th day.Conclusion. Following the obtained results the use of dual-wavelength photodynamic therapy can be considered as a promising method for restoration of the microvasculature of tissues in the oral mucosal trauma.

Extramammary Paget's disease is a slow-growing cutaneous intraepithelial adenocarcinoma of the apocrine glands in the anogenital and axillary regions. The disease is extremely rare, affects predominantly postmenopausal women, and has nonspecific clinical caracteristics, so that it can take 210 years from the first clinical signs to diagnosis. The vulva and the perianal region are the most affected zones. Extramammary Pagets disease is clinically manifested as well-defined erythematous plaques with secondary changes, such as scaling, ulceration and even bleeding. Differential diagnosis is made between primary and secondary forms of Extramammary Pagets disease, candidiasis, contact dermatitis, Crohn's disease, eczema, erosive lichen planus, hydradenitis suppurativa, Langerhans cell histiocytosis, sclerosing lichen, psoriasis, squamous cell carcinoma in situ, amelanotic melanoma and mycosis fungoide. Treatment mainly includes the surgical component, as well as the use of photodynamic therapy, cytostatic agents, and, depending on the stage, systemic chemotherapy.

The review paper provides brief analysis of phototherapy methods used in various dermatoses. Phototherapy can be prescribed in combination with drugs or used solo. Phototherapy methods based on using the medium-wavelength (UVB) and long-wavelength (UVA) ultraviolet radiation are most commonly used in clinical practice: PUVA therapy and narrow-band UVB (311 nm) therapy, as well as treatment with excimer light with the wavelength of 308 nm. Photodynamic therapy combining photosensitizer, oxygen and visible light also gradually takes leading positions in aesthetic medicine and dermatology.

Prostate cancer (PСa) is one of the leading causes of cancer morbidity in men. The incidence of localized PCa is higher in high-income countries. There are different types of treatment for localized PCa: from active surveillance to focal therapy or radical treatment. Both patients and urologists are interested in minimizing side effects of treatment, so focal therapy is an alternative option. Magnetic resonance imaging is one of the leading tools either for primary diagnosis or for following evaluation of treatment efficacy, including focal therapy. Therefore, we summarized literature data published on this topic.

Photodynamic therapy is a modern and proven type of treatment for both nononcological or precancerous processes, and various oncological diseases, including basal cell skin cancer and squamous cell carcinoma of various localizations. The key elements of photodynamic therapy are a light source with a certain wavelength, which acts as an activator for non-toxic photosensitizers, which, in turn, contributes to the creation of reactive oxygen species, which provide the main therapeutic effect. Currently, photodynamic therapy remains the subject of research, despite its long historical path. Many new developments and trends that are relevant for practical application have been proposed. On the one hand, these are the possibilities of modifying the main components of PDT; various therapeutic combinations have also been developed that lead to an increase in the effectiveness of therapy. For example, the use of nanocarriers makes it possible to implement a targeted method and, as a result, increase the selectivity of photodynamic therapy, which provides a better result with fewer side effects. This article provides an overview of the current progress in the use of photodynamic therapy for the treatment of malignancies and presents new preclinical bioengineering approaches that can solve problems in this area and thus increase the effectiveness and usefulness of such treatments.

Chronic venous insufficiency, being the outcome and complication of most diseases of the veins of the lower extremities, is the fundamental cause of the formation of trophic ulcers. Over the past decade, in solving the problem of treating venous trophic ulcers, certain successes have been achieved, both in theoretical and practical terms. The modern concept of curation of patients with trophic ulcers of venous origin involves a reasonable combination of the following methods of treatment: local, including compression, as well as medical, surgical, minimally invasive and additional methods (physiotherapy, photodynamic therapy, etc.). The main goal of the treatment is to eliminate the ulcer, after which measures are taken to correct the underlying cause (chronic venous insufficiency) and prevent relapse. However, the tactics of the most successful treatment of patients with trophic ulcers of venous etiology is still not defined and requires further improvement. In particular, the method of photodynamic therapy, which includes the usage of special drugs - photosensitizers, also deserves to be studied and expanded for clinical use. The mechanism of photodynamic action is based on the ability of photosensitizers to accumulate in microbial and pathological cells. Under local light exposure, the photosensitizer enters an excited state and charges oxygen, which is associated with erythrocyte hemoglobin. Thus, in cells under the influence, a photochemical reaction is triggered, which ensures the formation of singlet oxygen and its free radicals. Reactive oxygen species, in turn, have a damaging effect on pathogenic flora and necrotic tissues. The main advantages of the method are relative simplicity, no risk of developing antibiotic resistance, acceleration of reparative and regenerative processes, and prevention of secondary infection. Thus, photodynamic therapy allows non-invasive, safe and effective optimization of local treatment and preoperative preparation of patients with venous trophic ulcers.

Introduction. The article presents the results of photodynamic therapy (PDT) of extrahepatic bile ducts (EBD) and large duodenal papilla (LDP) cancer in inoperable patients. The technique of its carrying out and ways of delivery of laser light guides to various parts of biliary tract are described. Efficiency of PDT for cancer of LDP and separately for cancer of EBD was determined. The dependence of patients' life expectancy on the number of PDT sessions during a year was revealed and the comparative analysis of two groups of photosensitizers (PS) efficiency was carried out.Research purpose: to estimate the effectiveness of photodynamic therapy (PDT) in treatment of VUC and IBD cancer; to determine the reasonability of repeated PDT courses and time intervals between them; to compare the effectiveness of photosensitizers Photodetazine and Photosens in treatment of these patients.Materials and Methods. The study was based on a comparative analysis of life expectancy in inoperable groups of patients with VVC and IBD cancer. The main group consisted of 29 patients (including 20 patients with IBD cancer) who were treated by PDT besides biliary operations. Control group consisted of 50 patients (14 of them with BDZ cancer), only biliary drainage interventions were used in their treatment. The number of PDT courses performed was from 1 to 3 during the year. A total of 29 patients underwent 52 courses of PDT. We used two photosensitizers from different groups: Fotoditazin (chlorine derivative E6) – was used in 18 patients and Photosense (phthalocyanine derivative) – was used as PS in 11 patients. Assessment of treatment efficacy was based on determining the median survival according to the Kaplan-Meier method.Results. Median survival time in the main group was 18 months [95% CI: 15.9; 20.1], in the comparison group (without PDT) – 7 months [95% CI: 5.1; 8.9]. In patients with IBD cancer, the median survival for PDT was 18 months [95% CI: 16; 20], and 12 months [95% CI: 9.25; 14.75] in the comparison group. Life expectancy for patients with BDS cancer ranged from 1 to 60 months. Median survival time was 17 months [95% CI: 12; 21] in case of Fotosens – 18 months [95% CI: 16; 19]. In the group of patients who underwent one PDT session during a year, median survival time was 12.5 months [95% CI: 10; 15], in the group of patients who underwent 2 or more sessions, median survival time was 23 months [95% CI: 18; 28].Conclusions. Photodynamic therapy in combination with draining interventions on bile ducts is an effective method of therapy of inoperable forms of IVC and IBD carcinoma in high risk patients. Variants of delivery of laser radiation for PDT are developed. Repeated sessions of PDT at intervals of 4-6 months potentiate the effectiveness of palliative therapy and increase life expectancy of patients. The effectiveness of Fioditazine and Photosense in PDT was found to be similar. Fotoditazine showed a lower number of complications.

Photodynamic therapy (PDT) in the treatment of psoriasis remains the subject of much debate. There is no consensus in the scientific community about effective and safe PDT regimens for psoriasis. Described in the published materials doses and concentrations of photosensitizers for psoriasis, as well as light doses, differ by dozens of times. The purpose of this review is to analyze the efficacy and safety profile of various PDT regimens for psoriasis. Some studies demonstrate 100% effectiveness of the method in certain modes (complete or partial clearance of psoriasis foci after PDT). In particular, such efficiency was obtained with the application of 20% 5-ALA (light dose 15 J/cm2) and 0.1% methylene blue (light dose 15 J/ cm2). The main factor limiting the use of PDT in psoriasis, and in some cases even being the reason for treatment interruption, is severe pain during the irradiation procedure. This requires careful development of PDT regimens in patients with psoriasis.

The most commonly detected non-melacytic skin tumor in humans is "basal cell carcinoma". There are many clinical varieties of this tumor, some of which are quite rare. The attention of specialists is brought to the attention of a clinical observation of an elderly woman who was observed on an outpatient basis by a dermatologist with a rare form of basal cell carcinoma of the skin of the back. Of particular interest is a long history of the disease for about 15 years, the presence of a scar-like large lesion on the back of more than 11 cm in diameter, the absence of lymphadenopathy and weight loss, with a histologically confirmed sclerodema-like basalioma of the skin.

Background and Objectives: Bladder cancer is one of the ten most common cancers causing a high mortality rate. Photodynamic therapy (PDT) is one of the promising ways to treat this disease. To increase the effectiveness of PDT it is necessary to ensure selective delivery of photosensitizer to the tumor. Selective delivery systems such as nano- and microparticles of calcium carbonate in the polymorphic modification of vaterite are of great interest to solve this problem. Therefore, the aim of this study was to investigate submicron particles of vaterite as agents for selective delivery of photosensitizer PzBn on human bladder T24 cell culture. Materials and Methods: Calcium carbonate particles were obtained by mixing equimolar solutions of CaCl2 and Na2CO3 salts in the presence of glycerol. PzBn was immobilized by adsorbing the substance on preliminarily synthesized vaterite particles. The loading efficiency was evaluated using the spectrophotometric method. The experiments were carried out on the T24 human bladder carcinoma cell line. Intracellular localization was assessed using fluorescent laser confocal scanning microscopy. The study of the dynamics of PzBnVp accumulation by cells was carried out by spectrophotometry. Dark toxicity and photodynamic activity were analyzed using the MTT test. Results: The efficiency of loading porphyrazine into vaterite particles is over 9%. It has been shown that PzBnVp is characterized by rather rapid accumulation by T24 cells: the maximum accumulation is recorded already 30 minutes after its addition, after which the intensity of the fluorescence signal remains at a constant level for 5 hours of observation. It has been demonstrated that PzBnVp is characterized by low dark toxicity with high photodynamic activity. Conclusion: The possibility of loading vaterite particles with the photodynamic dye porphyrazine has been demonstrated. A high rate of entry of vaterite particles into the cell and the release of the loaded photosensitizer from particles and its subsequent redistribution over subcellular structures have been shown. The preservation of the photodynamic activity of porphyrazine in the composition of vaterite particles and the absence of dark toxicity in the studied concentration range have been demonstrated. Vaterite particles can be considered as promising agents for the selective delivery of porphyrazine to the tumor in order to increase the efficiency of photodynamic therapy.

Objective: studying of the effect of combined antioxidant and photodynamic therapy (PDT) on the emotional state of patients with vulvar kraurosis. Materials and methods: the study involved 90 women with vulvar kraurosis who were randomized into three groups of 30 participants. In the first group, treatment included photodynamic therapy (PDT) followed by administration of the antioxidant Ethylmethylhydroxypyridine succinate for one month. Participants in the second group received only PDT. Patients of the third group underwent a course of laser therapy on the perineal region. The emotional state of the participants was assessed using the Hospital Anxiety and Depression Scale (HADS) before and at the end of treatment, 1, 6 and 12 months after the end of therapy. Results: before treatment, participants from the three groups scored a similar number of HADS scores. In the course of observations, the best result on the scales of anxiety and depression was recorded in patients who received combined antioxidant and photodynamic therapy. After a month of taking Ethylmethylhydroxypyridine succinate, the HADS score in these women was significantly lower than in the comparison groups. Further, these patients continued to show better scores on the depression scale. The total scores on the anxiety scale in this group were comparable to those in patients who received only PDT. Conclusion: combined antioxidant and photodynamic therapy, including Ethylmethylhydroxypyridine succinate, has a more pronounced positive effect on the emotional background of patients with vulvar kraurosis in comparison with PDT and laser therapy.

The problem of oncological diseases has acquired a social and medical character. In this regard, the rapid development of new drugs and methods, as well as modification of existing methods in order to increase their effectiveness, is currently required. The paper aims to develop and study two promising agents for photodynamic therapy. We discussed a new binary complex based on the widely used photosensitizer chlorin E6 with europium, which can solve one of the main disadvantages of drugs for photodynamic therapy: it can be used to treat deeper tumors and act more effectively by transferring luminescence energy between europium and chlorin E6. Our other agent was copper-containing chlorophyllin. Chlorophyllin is a natural component, which is always promising in the development of new drugs. The optical and fluorescent parameters of the agents were determined using physicochemical methods; their ability to generate reactive oxygen species in the presence of two fluorescent probes was studied: 2ʹ, 7ʹ-dichlorodihydrofluorescein and dihydrofluorescein. Thus, we showed the effectiveness of chlorophyllin in comparison with chlorin E6 by 1.92 times at 50 μg / ml E6 and showed the effectiveness of the binary complex even at the minimum concentration of 10 μg / ml. Further research in cell cultures will develop the ways of the possible use of new substances as photosensitizers.

We report the experience of radical treatment by photodynamic therapy of patients with squamous cell carcinoma of oral cavity with serious side diseases. Completed treatment of two patients with serious side diseases (HIV infection with associated pulmonary hypertension of high degree and cardiac pathology) suffered from cancer of oral cavity. Extensive surgical treatment and/or aggressive course of chemoradiation therapy were not indicated to them due to concomitant pathology. Both patients were diagnosed with squamous cell carcinoma of oral cavity, with appropriate stage Ist. сT1N0M0. Patients received treatment by photodynamic therapy with chorine photosensitizer in dose 1 mg/kg. Options of photodynamic were: output power – 1.5W, power density – 0.31 W/cm2, light dose – 300 J/cm2. After one time session of photodynamic therapy, in both cases full response was diagnosed (according to RECIST 1.1). In one case the second session of photodynamic therapy was performed due to concomitant disease of oral cavity – multiply lesions of leukoplakia and after was diagnosed full remission of all lesions. Major adverse event was pain during the first 5-7 days after treatment, curable by painkillers. Follow-up (IQR) was 12 and 18 month respectively with no evidence of progression. It is available to avoid extensive surgical treatment and aggressive course of chemoradiation therapy (as an alternative) with the use of photodynamic therapy. Photodynamic therapy is minimally invasive method of radical treatment of localized squamous cell carcinoma of oral cavity with minimal adverse events, and could be especially relevant in patients with serious concomitant diseases.

The article presents the results of a study of survival after complex palliative treatment of patients with malignant tumors of the pancreas stage IV in two comparable groups of patients. The aim of the study is to determine the prognostic factors affecting survival in patients with stage IV pancreatic cancer who received local and systemic photodynamic therapy. In the main group, which consisted of 19 patients with histologically veried stage IV pancreatic maligant tumor, palliative treatment was performed using photodynamic therapy. In the comparison group, consisting of 28 patients with histologically veried malignant tumor of the pancreas stage IV, palliative treatment was performed without the use of photodynamic therapy. On the background of the use of local and systemic photodynamic therapy in the main group it was observed a statistically significant increase in life expectancy compared with the comparison group. The three-month survival of patients who received local and systemic photodynamic therapy is affected by the level of brinogen before treatment. The level of brinogen above 3.4 g/l makes it possible to predict a decrease in the probability of three-month survival after photodynamic therapy. Thus, complex treatment with the use of photodynamic therapy for stage IV malignant tumors of the pancreas can increase the survival rate of patients.

Nowadays, photodynamic therapy (PDT) is a high-technology actively developing treatment method used in clinical medicine. An interest in this method is primarily due to the fact that its destructive action is based on the mechanisms of free radical oxidation, altered tumor vascular stroma and immune cell-mediated elimination. Owing to current research, improving the quality of photosensitizers and light sources, it becomes possible to expand indications for using this method beyond oncological practice. Generalized data on PDT effectiveness and safety for the treatment of cervical lesions, as well as the ease to use, allow us to attribute this technique to some promising approaches.

The aim of the study is to study the results of the most significant studies on the forms of tumor cell death and targets in photodynamic therapy (PDT). Material and methods. On the problem, we analyzed the Scopus, WoS, MedLine databases and found 31 sources. Results. PDT is an important tool for studying the pathways leading to the complete devitalization of a malignant tumor. Moreover, subcellular targets in pdt are determined by the properties of photosensitizers (PS). Particularly effective targets are lysosomes and mitochondria, including those for class I PS, photofrin. This explains the effectiveness of photofrin, although it has a weak absorption band in the region of 630 nm with a limited penetration depth into tissues. The development of new PSs with subcellular targets of photofrin, but with an absorption band in the long-wavelength region, is becoming very topical. Such FS are ideal for PDT. Second-generation PSS have already been introduced into clinical practice. The effectiveness of PDT with the use of photoditazine was shown. The mechanisms of action and targets of this PS have been established. The latter include the vessel wall, cytoplasmic membranes, and internal structures of tumor cells. The main type of neoplastic cell death during PDT with photoditazine is direct photocoagulation and ischemic necrosis of the tumor parenchyma due to the destruction of the neoplasm vascular bed. Today, considerable attention is paid to the development of other new PSS, namely, bacteriochlorophyll-α derivatives, which have an intense absorption of radiation in the long-wavelength region of the spectral range. These include the disulfide-bpi conjugate, which contains 2 molecules of dipropoxybacteriopurpurinimide and a cystamine residue, the results of which showed its high efficiency due to the destruction of the tumor vascular bed, the rapid slowdown and/or cessation of cell proliferative activity and their death by necrosis and apoptosis. Rapid progress in studying the mechanisms of action of PDt has shown that autophagy triggering using the lysosomal compartment to degrade and utilize damaged cell organelles and paraptosis associated with defective proteins in the endoplasmic reticulum also play an important role in the elimination of tumor cells. Conclusion. Apoptosis, autophagy, and paraptosis can occur after photodamage to mitochondria, lysosomes, or the endoplasmic reticulum. The balance of cell death pathways is often a determining factor in the effectiveness of PDT.

Treatment of poorly-pigmented tumors of small sizes can be carried out using photodynamic therapy (PDT). The material for the analysis was data on 112 patients. We used data from the Belarusian Cancer Registry, medical records of patients with clinically diagnosed choroid melanoma (C69.3 according to ICD-10) for the period 2013–2021. The size and level of blood flow in the tumors were assessed using an ultrasound machine with a doppler attachment. PDT was carried out using a «UPL PDT» semiconductor laser (Lemt, Republic of Belarus, λ=661 nm) with a light spot diameter of 1 to 3 mm for 60 s per field with a light dose of 50 J/cm2. The entire surface of the tumor was exposed to the action, with the fields “tiled”, from the periphery to the top of the tumor, with overlapping fields. Tumor pigmentation was assessed visually. To evaluate the treatment outcome, the general group of patients was divided into three subgroups according to thickness and basal diameter. Group I – 40 (35.7%) patients, with an average tumor thickness of 1.4±0.2 mm, basal diameter – 5.8±1.5 mm. II – 51 (45.5%) patients, with an average tumor thickness of 2.3 ± 0.3 mm, basal diameter – 7.9 ± 1.5 mm. III – 21 (18.8%) patients. The mean value of the tumor thickness was 3.8±0.4 mm, the basal diameter was 9.8±1.4 mm. After PDT in the general group (n=112), 29 (25.9%) patients had complete tumor resorption, and 83 (74.1%) patients had stabilization. The eyeball was saved in 107 (95.5%) patients. Continued growth and relapse were recorded in 34 patients: 25 (22.3%) and 9 (8.0%), respectively. In 29 (85.3%) patients, the eyeball was preserved after treatment of relapse and continued growth. 5 (4.5%) enucleations were performed. Adjusted one-year cumulative survival was 100%, 3-year and 5-year 95.8±2.4%, 93.7±3.1%, respectively

The article describes a clinical example of timely, safe and effective photodynamic therapy (PDT) in a patient diagnosed with human papillomavirus (HPV) CIN I-associated cervical cancer after ineffective vaccination with 4-valent Gardasil vaccine. Clinical case demonstrates the low effectiveness of HPV vaccination in patients with established HPV infection. In this patient, the lack of adequate treatment for about 1.5 years led to the development of HPV associated CIN I of the cervix. Center for Laser and Photodynamic Diagnostics and Therapy of Tumors and MRI P.A. Herzen, the patient underwent a course of antiviral PDT with the achievement of complete regression of dysplasia and complete eradication of HPV viruses. The patient tolerated the treatment well, without complications. The period of relapse-free follow-up is 19 months.

Extramammary Paget’s disease (EMPD) is a rare tumor that predominantly affects the skin containing apocrine glands. Due to insufficient data on the effectiveness of different methods, there is no single therapeutic approach to the treatment of patients with EMPD and their subsequent management. The use of surgical methods, laser therapy and local cytotoxic drugs has a number of limitations. The advantages of using photodynamic therapy (PDT) in EMPD are the absence of systemic toxicity, non-invasiveness, selectivity of action, the absence of carcinogenic potential, the possibility of conducting several courses of treatment, and good cosmetic results. In our review, we analyzed those published in 2000-2022 data on the results of PDT treatment of 114 patients with EMPD. As a result of treatment, complete regression of tumor foci was achieved in 40% of patients. Most authors note that PDT is more effective for small areas (up to 4 cm2).

Photodynamic therapy (PDT) is one of the most effective treatments for basal cell skin cancer (BCC). As the incidence rate of BCC is increasing worldwide, interest in developing new methods for diagnosing and treating this disease, taking into account long-term cosmetic results, is growing. The review article presents the results of domestic and foreign studies on the treatment of BCC with PDT. The presented results of studies from various domestic and foreign clinics indicate the high efficiency of independent PDT and a combination of PDT with other treatment methods. PDT is proposed to be used in combination with surgical methods and radiation therapy, immunomodulating and chemotherapeutic agents, and inhibitors of molecules involved in the carcinogenic process. These new strategies open the way to increasing the effectiveness of treatment and prevention of BCC. Moreover, in all studies, the safety of this non-invasive treatment, a low level of adverse reactions during therapy, good tolerance for the patient and excellent cosmetic treatment results are noted. The guidelines currently being developed in Europe and the United States provide consistent expert advice that reflects current published evidence of treatment outcomes for BCC using PDT. Moreover, the recommendations emphasize that the treatment plan for patients with “difficult to treat” BCC should be discussed at an interdisciplinary oncological council.

The proposed approach to microcirculation assessment is non-invasive, informative, and can be implemented during photoactivation, and thus is perspective both for research tasks and clinical practice. The functional principles of the vasculature response to photodynamic exposure, identified using this technique, also foster the efficiency and safety of photodynamic therapy. The developed setup allows simultaneous photodynamic exposure and studying the microcirculation parameters by videocapillaroscopy and photoplethysmography techniques. Photodynamic action is carried out by 662 nm laser radiation with a power density of 15 mW/cm2 in continuous and pulsed modes. The imaging system of the setup consists of a large working distance microscope, an optical filter, and a monochrome camera. The illumination system is based on LED with a central wavelength of 532 nm. The acquired images were processed in order to obtain morphometric and hemodynamic microcirculation data in the inspected skin area. To compare the proposed approach with existing methods, we measured blood flow parameters by a laser Doppler flowmeter. We tested the developed setup on rats injected with a photosensitizer and obtained active vessel maps, photoplethysmograms, and skin vessel density values before, during, and after photoactivation in both generation modes. The proposed approach allows to reveal differences in the microcirculation response to photodynamic effects of low power densities in different modes, in particular, the discrepancy between the time from the start of exposure to the cessation of blood flow and the start of the recovery period.

The authors studied the antitumor efficacy of photodynamic therapy (PDT) in combination with radiodynamic therapy (RDT) in an in vivo experiment. The study was approved by the Ethics Committee of the N.N. Alexandrov National Cancer Center of Belarus (protocol dated February 25, 2022, № 180). The work was performed on 26 white non-linear rats weighing 200 ± 50 g. Pliss lymphosarcoma (PLS) was used as a tumor model, which was transplanted subcutaneously. Photosensitizer (PS) «Photolon» (RUE «Belmedpreparaty», Belarus) was administered intravenously at a dose of 2.5 mg/kg of body weight. The RDT session was performed by the contact method (CRT) once 2.5–3 times after the end of the infusion of the PS on the «microSelectron-HDR V3 Digital apparatus» (Elekta, Sweden) using γ-radiation (192Ir) in a single focal dose 6 Gy. A PDT session was performed once immediately after exposure to ionizing radiation using a «PDT diode laser» (LTD Imaf Axicon, Belarus, λ=660±5 nm) at an exposure dose of 100 J/cm2 with a power density of 0.2 W/cm2 and a power of 0.353 watts. All rats were divided into 4 groups of 6–7 animals each: intact control (IC), PS + PDT, PS + CRT, PS + CRT + PDT. The criteria for evaluating antitumor efficacy were: the average volume of tumors (Vav, cm3 ), the coefficient of absolute growth of tumors (K, in RU), the coefficient of tumor growth inhibition (TGI, %), the frequency of complete tumor regressions (CR, %), the proportion of cured rats (%), an increase in the average duration of dead rats (%). Differences were considered statistically significant at p

The study included 30 patients who were diagnosed with acute bacterial prostatitis. The average age of the patients was 32 ± 2 years. The study included patients who gave their consent to participate, who did not have concomitant pathology, which was documented, whose age ranged from 18 to 40 years. Patients over 40 years of age with chronic diseases, patients with an established diagnosis of chronic prostatitis were excluded. All patients were divided into two groups of 15 people. The first (group 2) included patients with OBP who were treated with antibacterial drugs in combination with photodynamic therapy and magnetolaser exposure. The second group (group 1) included 15 patients who received antibacterial therapy and magnetolaser exposure without photodynamic therapy. As a result of the study, it was found that the use of combination therapy leads to faster (on the third day) changes in the microflora and relief of symptoms of acute bacterial prostatitis.

Photodynamic therapy (PDT) is known as a routine treatment method in which cell survival index like viability plotted versus 1O2 concentration or light fluence in the form of a curve. In this paper, a mathematical model was proposed with ability of generating a mirrored-sigmoid curve which seems to be fitted to any experimental data relating to cell viability, survival probability or any cellular index representing living conditions through adjusting three parameters. It was validated by showing an excellent curve fitting relatively with data obtained from cancerous lung cells under ALA-PDT process in vitro. It was tried to define the relations between model’s parameters and biological/clinical factors with the curve regions of plateau (at low doses; non- sensitive part), steep (high-sensitive part), and steady state (at high doses; low-sensitive part). It seems this model could be excellently fitted to any data presenting the cell-living index versus the killer agent in «any cancer therapy technique (e.g. radiotherapy)». Although this claim showed to be correct for PDT, different relevant data of other researchers should also be used for this model and other usual models too, in order to compare their fitness rates.

The review highlights the current understanding of the epidemiology, etiology, pathogenesis, existing classifications of mycosis fungoides. Methods for diagnosis and treatment of the pathology are described, among which photodynamic therapy (PDT) plays an important role. The main advantages of PDT for mycosis fungoides include the absence of systemic toxicity, non-invasiveness, selectivity, absence of carcinogenic potential, the possibility of repeated courses of treatment, and good cosmetic results. This review collects and analyzes the results of clinical trials of PDT in patients with mycosis fungoides. The analysis showed high efficiency of PDT in patients with mycosis fungoides with isolated or limited spots and plaques. PDT can be considered as the therapy of choice in patients with facial lesions when a good cosmetic result is one of the main requirements, and radiation therapy, nitrogen mustard or carmustine can leave permanent and visible scars. Plaques located in the axillary or inguinal skin folds that are inaccessible to phototherapy can also be treated with PDT.

The effect of photodynamic therapy (PDT) on the level of matrix metalloproteinases in squamous cell skin cancer (SCSC) was studied. The study involved 202 people, including 185 patients with SCSC, who were on outpatient and inpatient treatment in medical institutions of Engels and Saratov during the period from 2015 to 2019, and 17 donors. The study design included studies in three main groups. The first (intervention) group included 74 (36.6%) patients with SCSC who underwent combined treatment, including PDT at the first stage and surgical treatment at the second stage. The second group consisted of 111 (55.0%) patients with SCSC who underwent only surgical treatment. The third group consisted of 17 (8.4%) relatively healthy volunteer donors, comparable in age and sex with the patients of the main group. As a result of the study, it was found that the level of metalloproteinase-1 inhibitor (TIMP-1) in the blood serum of patients with SCSC was reduced compared with physiologically normal indicators, which led to a statistically significant increase in matrix metalloproteinases (MMPs) MMPs-2, MMPs-7 and MMPs-9. Performing only surgical treatment for this pathology does not lead to a complete recovery of these indicators. However, the use of combined treatment including PDT showed a statistically significant increase in the amount of TIMP-1 before the start of surgical treatment, which naturally led to a decrease in MMPs-2, MMPs-7 and MMPs-9. Later, after excision of the tumor, the patients of this group had a complete normalization of TIMP-1, which, in turn, contributed to a decrease and then restoration of the number of MMPs-2, MMPs-7 and MMPs-9 to physiologically normal values.

In this clinical study, the effect of photodynamic therapy and ultraviolet radiation on the effectiveness of the treatment of periodontal diseases was examined according to the results of an index assessment. Clinical examination of 95 patients of both sexes aged from 18 to 32 years revealed chronic generalized catarrhal gingivitis (K05.1). The main index criteria for comparative parameters in all study groups were: simplified OHI-S hygiene index, Mullemann-Cowell bleeding index, PMA index. The indices were measured before and after treatment with subsequent control examinations in 1 month, 3 months, 6 months. The patients were divided into three groups and each group underwent standard periodontal treatment aimed at stopping the inflammatory process and preventing its further development. In the first group, the treatment was supplemented with the use of the FotoSan LED lamp with a wavelength of 630 nm, in the second the “Quasar” ultraviolet irradiator was used, in the third (control) group, the complex of therapeutic measures was carried out without physiotherapeutic procedures. According to the results of the study, the use of photodynamic therapy significantly accelerates the regenerative processes of periodontal epithelial tissue and reduces the number of treatment sessions.

Actinic keratosis is an important medical and social problem, the correct diagnosis and treatment of which will help to avoid the development of invasive forms of cutaneous squamous cell carcinoma. With the further development of the early diagnosis of cancer, including skin cancer, the increase in human life expectancy, and the popularization of travel to exotic countries, the number of cases of actinic keratosis among the population will continue to grow. In this regard, it is important to discuss the causes and pathogenesis of the disease, the varied clinical picture of the disease, methods of non-invasive diagnostics, as well as methods of treatment, of which there are a great many in the treatment of actinic keratosis today. However, each of the methods has both advantages and disadvantages, and in the global trend towards a personalized approach to treatment, it is important to choose from the standpoint of evidence-based medicine the most suitable for each individual patient. Moreover, after treatment of actinic keratosis, relapses often occur, which are the result of insufficient diagnosis and the development of incorrect treatment tactics. The review article provides the clinical picture of actinic keratosis, diagnostic and therapeutic methods, and their comparison with each other in terms of efficacy and safety

The article presents a literature review of studies on the use of local destruction methods (photodynamic therapy and radiofrequency ablation) in the treatment of patients with unresectable extrahepatic cholangiocarcinoma. Currently, many studies have been published on the assessment of photodynamic therapy in the treatment of patients of this category. Radiofrequency ablation in tumors of extrahepatic bile ducts has been used relatively recently, but, according to available data, it may represent an alternative to photodynamic therapy. The article discusses the mechanism of action, the method of photodynamic therapy and radiofrequency ablation, and presents the results of the largest studies. It is reported that photodynamic therapy is comparable to R1/R2 resection according to the survival results. There is evidence of its successful use as adjuvant and neoadjuvant treatment, the possibility of using photodynamic therapy as a method of local tumor control in patients with unresectable cholangiocarcinoma awaiting liver transplantation. The use of radiofrequency ablation at the first stage before stenting the biliary tract allows to increase the diameter of the bile ducts, increases the stent patency time, as well as the survival orate f patients. In addition, radiofrequency ablation and photodynamic therapy can be successfully applied to occlude previously inserted stents. The advantage of photodynamic therapy is the possibility of using it in weakened patients with hyper bilirubinemia. The advantages of radiofrequency ablation include the lower cost of the procedure, as well as the absence of the need to keep the light regimen. The prospects of using methods of locoregional destruction as part of combined treatment regimens (in combination with systemic or regional chemotherapy) are being studied, which allows achieving the best results.