Efficacy and safety of photodynamic therapy for recurrent, high grade nonmuscle invasive bladder cancer refractory or intolerant to bacille calmette-Guérin immunotherapy

Joo Yong Lee, Richilda Red Diaz, Kang Su Cho, Meng Shi Lim, Jae Seung Chung, Won Tae Kim, Won Sik Ham, Young Deuk Choi

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose We evaluated the effectiveness of photodynamic therapy using Radachlorin® in patients with high grade, nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Guérin therapy who refused radical cystectomy. Materials and Methods Between July 2009 and December 2011 photodynamic therapy was performed in 22 men and 12 women. Radachlorin (0.5 to 0.6 mg/kg) was injected intravenously 2 to 3 hours before photodynamic therapy. After complete transurethral resection, a diffuser using a 22Fr cystoscope was placed in the bladder for irradiation with a 662 nm laser. Output beam power was adjusted to 1.8 W and the light dose was 15 J/cm2. Photodynamic therapy was performed for 16 to 30 minutes. Recurrence after photodynamic therapy was followed by regular cystoscopy at 1, 2 and 3 months, and at 3-month intervals thereafter for up to 2.8 years. Efficacy was assessed by cystoscopy, cytology and histology, and defined as the number of patients who were tumor free after initial photodynamic therapy. Results Mean ± SD patient age was 62.94 ± 8.71 years. Average followup was 26.74 ± 6.34 months (median 28.12). As the primary efficacy outcome, the recurrence-free rate was 90.9% at 12 months, 64.4% at 24 months and 60.1% at 30 months. As the secondary efficacy outcome, there was no statistical difference in mass size, carcinoma in situ, number of previous bacillus Calmette-Guérin administrations, number of transurethral bladder resections or tumor multiplicity on Kaplan-Meier analysis (each p >0.05). No evidence of severe adverse effects was detected after photodynamic therapy. Conclusions Photodynamic therapy with Radachlorin is a safe, effective treatment for nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Guérin therapy in select patients.

Original languageEnglish
Pages (from-to)1192-1199
Number of pages8
JournalJournal of Urology
Volume190
Issue number4
DOIs
Publication statusPublished - 2013 Oct 1

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Photochemotherapy
Urinary Bladder Neoplasms
Immunotherapy
Safety
Bacillus
Cystoscopy
Urinary Bladder
Cystoscopes
Recurrence
Cystectomy
Carcinoma in Situ
Kaplan-Meier Estimate
Cell Biology
Neoplasms
Histology
Lasers
Therapeutics
Light

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Lee, Joo Yong ; Diaz, Richilda Red ; Cho, Kang Su ; Lim, Meng Shi ; Chung, Jae Seung ; Kim, Won Tae ; Ham, Won Sik ; Choi, Young Deuk. / Efficacy and safety of photodynamic therapy for recurrent, high grade nonmuscle invasive bladder cancer refractory or intolerant to bacille calmette-Guérin immunotherapy. In: Journal of Urology. 2013 ; Vol. 190, No. 4. pp. 1192-1199.
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abstract = "Purpose We evaluated the effectiveness of photodynamic therapy using Radachlorin{\circledR} in patients with high grade, nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Gu{\'e}rin therapy who refused radical cystectomy. Materials and Methods Between July 2009 and December 2011 photodynamic therapy was performed in 22 men and 12 women. Radachlorin (0.5 to 0.6 mg/kg) was injected intravenously 2 to 3 hours before photodynamic therapy. After complete transurethral resection, a diffuser using a 22Fr cystoscope was placed in the bladder for irradiation with a 662 nm laser. Output beam power was adjusted to 1.8 W and the light dose was 15 J/cm2. Photodynamic therapy was performed for 16 to 30 minutes. Recurrence after photodynamic therapy was followed by regular cystoscopy at 1, 2 and 3 months, and at 3-month intervals thereafter for up to 2.8 years. Efficacy was assessed by cystoscopy, cytology and histology, and defined as the number of patients who were tumor free after initial photodynamic therapy. Results Mean ± SD patient age was 62.94 ± 8.71 years. Average followup was 26.74 ± 6.34 months (median 28.12). As the primary efficacy outcome, the recurrence-free rate was 90.9{\%} at 12 months, 64.4{\%} at 24 months and 60.1{\%} at 30 months. As the secondary efficacy outcome, there was no statistical difference in mass size, carcinoma in situ, number of previous bacillus Calmette-Gu{\'e}rin administrations, number of transurethral bladder resections or tumor multiplicity on Kaplan-Meier analysis (each p >0.05). No evidence of severe adverse effects was detected after photodynamic therapy. Conclusions Photodynamic therapy with Radachlorin is a safe, effective treatment for nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Gu{\'e}rin therapy in select patients.",
author = "Lee, {Joo Yong} and Diaz, {Richilda Red} and Cho, {Kang Su} and Lim, {Meng Shi} and Chung, {Jae Seung} and Kim, {Won Tae} and Ham, {Won Sik} and Choi, {Young Deuk}",
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Efficacy and safety of photodynamic therapy for recurrent, high grade nonmuscle invasive bladder cancer refractory or intolerant to bacille calmette-Guérin immunotherapy. / Lee, Joo Yong; Diaz, Richilda Red; Cho, Kang Su; Lim, Meng Shi; Chung, Jae Seung; Kim, Won Tae; Ham, Won Sik; Choi, Young Deuk.

In: Journal of Urology, Vol. 190, No. 4, 01.10.2013, p. 1192-1199.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Efficacy and safety of photodynamic therapy for recurrent, high grade nonmuscle invasive bladder cancer refractory or intolerant to bacille calmette-Guérin immunotherapy

AU - Lee, Joo Yong

AU - Diaz, Richilda Red

AU - Cho, Kang Su

AU - Lim, Meng Shi

AU - Chung, Jae Seung

AU - Kim, Won Tae

AU - Ham, Won Sik

AU - Choi, Young Deuk

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Purpose We evaluated the effectiveness of photodynamic therapy using Radachlorin® in patients with high grade, nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Guérin therapy who refused radical cystectomy. Materials and Methods Between July 2009 and December 2011 photodynamic therapy was performed in 22 men and 12 women. Radachlorin (0.5 to 0.6 mg/kg) was injected intravenously 2 to 3 hours before photodynamic therapy. After complete transurethral resection, a diffuser using a 22Fr cystoscope was placed in the bladder for irradiation with a 662 nm laser. Output beam power was adjusted to 1.8 W and the light dose was 15 J/cm2. Photodynamic therapy was performed for 16 to 30 minutes. Recurrence after photodynamic therapy was followed by regular cystoscopy at 1, 2 and 3 months, and at 3-month intervals thereafter for up to 2.8 years. Efficacy was assessed by cystoscopy, cytology and histology, and defined as the number of patients who were tumor free after initial photodynamic therapy. Results Mean ± SD patient age was 62.94 ± 8.71 years. Average followup was 26.74 ± 6.34 months (median 28.12). As the primary efficacy outcome, the recurrence-free rate was 90.9% at 12 months, 64.4% at 24 months and 60.1% at 30 months. As the secondary efficacy outcome, there was no statistical difference in mass size, carcinoma in situ, number of previous bacillus Calmette-Guérin administrations, number of transurethral bladder resections or tumor multiplicity on Kaplan-Meier analysis (each p >0.05). No evidence of severe adverse effects was detected after photodynamic therapy. Conclusions Photodynamic therapy with Radachlorin is a safe, effective treatment for nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Guérin therapy in select patients.

AB - Purpose We evaluated the effectiveness of photodynamic therapy using Radachlorin® in patients with high grade, nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Guérin therapy who refused radical cystectomy. Materials and Methods Between July 2009 and December 2011 photodynamic therapy was performed in 22 men and 12 women. Radachlorin (0.5 to 0.6 mg/kg) was injected intravenously 2 to 3 hours before photodynamic therapy. After complete transurethral resection, a diffuser using a 22Fr cystoscope was placed in the bladder for irradiation with a 662 nm laser. Output beam power was adjusted to 1.8 W and the light dose was 15 J/cm2. Photodynamic therapy was performed for 16 to 30 minutes. Recurrence after photodynamic therapy was followed by regular cystoscopy at 1, 2 and 3 months, and at 3-month intervals thereafter for up to 2.8 years. Efficacy was assessed by cystoscopy, cytology and histology, and defined as the number of patients who were tumor free after initial photodynamic therapy. Results Mean ± SD patient age was 62.94 ± 8.71 years. Average followup was 26.74 ± 6.34 months (median 28.12). As the primary efficacy outcome, the recurrence-free rate was 90.9% at 12 months, 64.4% at 24 months and 60.1% at 30 months. As the secondary efficacy outcome, there was no statistical difference in mass size, carcinoma in situ, number of previous bacillus Calmette-Guérin administrations, number of transurethral bladder resections or tumor multiplicity on Kaplan-Meier analysis (each p >0.05). No evidence of severe adverse effects was detected after photodynamic therapy. Conclusions Photodynamic therapy with Radachlorin is a safe, effective treatment for nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Guérin therapy in select patients.

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