Comparison of different treatment schemes in 5-ALA interstitial photodynamic therapy for high-grade glioma in a preclinical model: An MRI study.


Journal

Photodiagnosis and photodynamic therapy
ISSN: 1873-1597
Titre abrégé: Photodiagnosis Photodyn Ther
Pays: Netherlands
ID NLM: 101226123

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 19 09 2018
revised: 14 11 2018
accepted: 07 12 2018
pubmed: 14 12 2018
medline: 26 9 2019
entrez: 14 12 2018
Statut: ppublish

Résumé

There is currently no therapy that prevents high-grade glioma recurrence. Thus, these primary brain tumors have unfavorable outcomes. Recently, 5-ALA photodynamic therapy (PDT) has been proposed to delay relapse and is highly expected to have potential synergistic effects with the current standard of care. However, PDT treatment delivery needs to be optimized by evaluating the impact of both the number of fractions and the light power used. Previous studies have reported MRI examination-based outcomes for PDT in glioblastoma. Our study aimed to compare MRI markers across different treatment schemes that use interstitial PDT in high-grade glioma in a preclinical model. Forty-eight "nude" rats were grafted with human U87 cells into the right putamen and subsequently submitted to interstitial PDT. The rats were randomized into six groups, including two different sham groups and four different treated groups (5 fractions at 5 mW or 30 mW and 2 fractions at 5 mW or 30 mW). After photosensitizer (PS) precursor (5-ALA) intake, an optical fiber was introduced into the tumor. Treatment effects were assessed with early high-field MRI to acquire T1 and T2 diffusion and perfusion images. There was no difference in the variation of the diffusion coefficient among the six groups (p = 0.0549, Kruskal-Wallis test). However, a significant difference was identified among the six groups in terms of variation in perfusion (p = 0.048, Kruskal-Wallis test), supporting a lesional effect in the treated groups. Additionally, the sham groups had significantly smaller edema volumes than were observed in the treated groups. Moreover, the 5-fraction group treated with 30 mW was associated with edema volumes that were significantly greater than those in the 5-fraction group treated with 5 mW (p = 0.019). Based on observations of MRI data and considering treatment effects, the 5-fraction group treated at 5 mW was not significantly different from the other treated groups in terms of cell deaths, characterized by diffusion imaging, or necrosis level. However, the significantly lower level of edema observed in this group indicated that this treatment scheme had limited toxicity.

Sections du résumé

BACKGROUND BACKGROUND
There is currently no therapy that prevents high-grade glioma recurrence. Thus, these primary brain tumors have unfavorable outcomes. Recently, 5-ALA photodynamic therapy (PDT) has been proposed to delay relapse and is highly expected to have potential synergistic effects with the current standard of care. However, PDT treatment delivery needs to be optimized by evaluating the impact of both the number of fractions and the light power used.
OBJECTIVES OBJECTIVE
Previous studies have reported MRI examination-based outcomes for PDT in glioblastoma. Our study aimed to compare MRI markers across different treatment schemes that use interstitial PDT in high-grade glioma in a preclinical model.
MATERIALS AND METHODS METHODS
Forty-eight "nude" rats were grafted with human U87 cells into the right putamen and subsequently submitted to interstitial PDT. The rats were randomized into six groups, including two different sham groups and four different treated groups (5 fractions at 5 mW or 30 mW and 2 fractions at 5 mW or 30 mW). After photosensitizer (PS) precursor (5-ALA) intake, an optical fiber was introduced into the tumor. Treatment effects were assessed with early high-field MRI to acquire T1 and T2 diffusion and perfusion images.
RESULTS RESULTS
There was no difference in the variation of the diffusion coefficient among the six groups (p = 0.0549, Kruskal-Wallis test). However, a significant difference was identified among the six groups in terms of variation in perfusion (p = 0.048, Kruskal-Wallis test), supporting a lesional effect in the treated groups. Additionally, the sham groups had significantly smaller edema volumes than were observed in the treated groups. Moreover, the 5-fraction group treated with 30 mW was associated with edema volumes that were significantly greater than those in the 5-fraction group treated with 5 mW (p = 0.019).
CONCLUSION CONCLUSIONS
Based on observations of MRI data and considering treatment effects, the 5-fraction group treated at 5 mW was not significantly different from the other treated groups in terms of cell deaths, characterized by diffusion imaging, or necrosis level. However, the significantly lower level of edema observed in this group indicated that this treatment scheme had limited toxicity.

Identifiants

pubmed: 30543907
pii: S1572-1000(18)30318-1
doi: 10.1016/j.pdpdt.2018.12.003
pii:
doi:

Substances chimiques

Biomarkers, Tumor 0
Photosensitizing Agents 0
Aminolevulinic Acid 88755TAZ87

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

166-176

Informations de copyright

Copyright © 2018. Published by Elsevier B.V.

Auteurs

Maximilien Vermandel (M)

Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France; Department of Neurosurgery, University Hospital, F-59000, Lille, France. Electronic address: maximilien.vermandel@chru-lille.fr.

Mathilde Quidet (M)

Department of Neurosurgery, University Hospital, F-59000, Lille, France.

Anne-Sophie Vignion-Dewalle (AS)

Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France.

Henri-Arthur Leroy (HA)

Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France; Department of Neurosurgery, University Hospital, F-59000, Lille, France.

Bertrand Leroux (B)

Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France.

Serge Mordon (S)

Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France.

Nicolas Reyns (N)

Univ. Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image-Assisted Laser Therapy for Oncology, F-59000, Lille, France; Department of Neurosurgery, University Hospital, F-59000, Lille, France.

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Classifications MeSH