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- Johansson, Ann, et al.
(author)
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Interstitial photodynamic therapy for primary prostate cancer incorporating realtime treatment dosimetry
- 2007
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In: Progress in Biomedical Optics and Imaging - Proceedings of SPIE. - : SPIE. - 1042-4687 .- 1605-7422. ; 6427, s. 4270-4270
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Conference paper (peer-reviewed)abstract
- Photodynamic therapy (PDT) for the treatment of prostate cancer has been demonstrated to be a safe treatment option capable of inducing tissue necrosis and decrease in prostate specific antigen (PSA). Research groups report on large variations in treatment response, possibly due to biological variations in tissue composition and shortterm response to the therapeutic irradiation. Within our group, an instrument for interstitial PDT on prostate tissue that incorporates realtime treatment feedback is being developed. The treatment protocol consists of two parts. The first part incorporates the pre-treatment plan with ultrasound investigations, providing the geometry for the prostate gland and surrounding risk organs, an iterative random-search algorithm to determine near-optimal fiber positions within the reconstructed geometry and a Block-Cimmino optimization algorithm for predicting individual fiber irradiation times. During the second part, the therapeutic light delivery is combined with measurements of the light transmission signals between the optical fibers, thus monitoring the tissue effective attenuation coefficient by means of spatially resolved spectroscopy. These data are then used as input for repeated runs of the Block-Cimmino optimization algorithm. Thus, the irradiation times for individual fibers are updated throughout the treatment in order to compensate for the influence of changes in tissue composition on the light distribution at the therapeutic wavelength.
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| 2. |
- Kalkner, Karl Mikael, et al.
(author)
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Octreotide scintigraphy and Chromogranin A do not predict clinical response in patients with octreotide acetate-treated hormone-refractory prostate cancer
- 2006
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In: Prostate Cancer and Prostatic Diseases. - : Springer Science and Business Media LLC. - 1476-5608 .- 1365-7852. ; 9:1, s. 92-98
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Journal article (peer-reviewed)abstract
- In this pilot study, the predictive value of Octreotide scintigraphy (Octreoscan) and/or Chromogranin-A (CgA) was investigated in patients with hormone-refractory prostate cancer treated with Octreotide acetate. In total, 20 patients with progressive disease and bone metastases entered the trial. At baseline Octreoscan, CgA, PSA, alkaline phosphates (ALP) and two self-administered questionnaires (EORTC QLQ C-30 (v3) and brief pain index) were performed and a diary of the pharmaceutical was started. The treatment consisted of Octreotide (Sandostatin LAR) acetate 30 mg intramuscular injection every month. The blood samples and questionnaires were repeated every month until 3 months. Clinical responder was defined as a patient with increased global health score more than 10 units and stable or decreased pain score without an increase in analgesic. In all, 17 patients were treated per protocol, and four were assessed as clinical responders. Six patients developed a reduction in ALP (median -26%, range -5 to -78%). All patients increased in PSA. At baseline, three patients had a negative Octreoscan and the patients with positive lesions, demonstrated uptake of low intensity. At baseline the CgA was elevated above the normal range in 15 of the patients, and during treatment five patients decreased their CgA to the normal range. Neither baseline Octreoscan nor CgA could identify the clinical reponders. A minority of patients improves their health-related quality of life. The decrease and normalization of CgA levels in five patients during therapy indicates therapeutic activity but Octreoscan and CgA could not identify clinical responders.
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