1. Photodynamic Therapy in Skin Cancer
- Author
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Gabriela Adriana Filip and Simona Clichici
- Subjects
Hematoporphyrin ,Chemotherapy ,business.industry ,medicine.medical_treatment ,Cancer ,Photodynamic therapy ,medicine.disease ,Targeted therapy ,Radiation therapy ,chemistry.chemical_compound ,chemistry ,medicine ,Cancer research ,Photosensitizer ,Skin cancer ,business - Abstract
In the last decades the improvements in cancer treatments were an important challenge both for physicians and researchers. The major aim was to obtain a targeted therapy that selectively destroys tumor cells, without affecting the normal tissues. For a very long period of time, the classical methods of treatment were surgery, chemotherapy and radiotherapy. Nevertheless, in most cases, the classical therapies are efficient only in the incipient stages and the solid tumors are often resistant to treatment. Two thirds of the patients are discovered in advanced stages of the disease. Even treated, their death occurs because of relapses and metastases. A quarter of the patients with a tumor in an operable stage can not benefit from the treatment because of their age and co-morbidities. They can only receive palliative therapy with a high relapse percentage. The concept of cellular death determined by the interaction of light with certain drugs was developed a century ago. The first to describe this process was Oscar Raab, in 1900. von Tappeiner and a dermatologist, Jesionek, used a combination between topically applied eosin and white light for the treatment of cutaneous tumors. In fact, Hermann von Tappeiner was the one who introduced the term “Photodynamic Therapy” (PDT) in clinical use, demonstrating the necessary presence of oxygen for the photosensitizing reaction to take place. In 1942, Auler and Banzer injected hematoporphyrin in tumor-bearing animals and observed that, after exposure to a halogen lamp fluorescence, the tumor necrosis appeared. The purification of hematoporphyrin, the use of its derivatives, and especially the introduction of LASER as a light source by Maiman led to improvements in the effects of this therapy. The modern era of PDT began in 1960 with the studies of Lipson and Schwartz, when they observed the red fluorescence of neoplasic lesions after the injection of hematoporphyrin compounds. Since then, considerable efforts have been made to improve the effects of this therapy. 5-aminolevulinic acid was used in 1990 by Kennedy and represented a major advancement in PDT. The first approved photosensitizer to be used on humans was Photofrin. Today, PDT is a non-invasive cancer therapy that associates the use of three components: the photosensitizer (PS), the light, and oxygen. PDT consists of the administration of a PS which accumulates in the lesion and the irradiation of the affected area with light in order to activate the drug. Thus, PDT becomes a treatment with double specificity. On one hand, PS accumulates selectively in the tumor, on the other hand the irradiation is targeted at the tumor. Several factors favor the selective accumulation of PS in tumor cells, including their high proliferation rate, the increased number of low density lipoprotein receptors, the increased vascular permeability, and the production of collagen which can bind the PS (Nowis et al, 2005).
- Published
- 2011
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