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A phase I study of Foscan-mediated photodynamic therapy and surgery in patients with mesothelioma.
[systemic capillary leak syndrome]
Photodynamic
therapy
(
PDT
)
is
a
light-based
cancer
treatment
that
,
in
the
correct
setting
,
can
be
delivered
intraoperatively
as
an
adjuvant
therapy
.
A
phase
I
clinical
trial
combining
surgical
debulking
with
Foscan-mediated
PDT
was
performed
in
patients
with
malignant
pleural
mesothelioma
.
The
purpose
of
the
study
was
to
define
the
toxicities
and
to
determine
the
maximally
tolerated
dose
(
MTD
)
of
Foscan-mediated
PDT
.
A
total
of
26
patients
completed
treatment
.
Tumor
debulking
was
accomplished
with
either
an
extrapleural
pneumonectomy
(
7
patients
)
or
a
lung
-sparing
pleurectomy-decortication
(
19
patients
)
.
Patients
were
injected
with
Foscan
before
surgery
,
and
652
nm
light
was
delivered
intraoperatively
after
completion
of
surgical
debulking
.
Four
light
sensors
were
placed
in
the
chest
,
allowing
delivery
of
light
to
a
uniform
measured
dose
throughout
the
hemithorax
.
F
our
dose
levels
were
explored
.
The
MTD
was
0
.
1
mg
/
kg
of
Foscan
injected
6
days
before
surgery
in
combination
with
10
J
x
cm
(
-
2
)
652
nm
light
.
Dose
limiting
toxicity
at
the
next
higher
dose
was
a
systemic
capillary
leak
syndrome
leading
to
death
in
2
of
3
patients
treated
at
that
dose
.
Other
PDT
-related
toxicities
included
wound
burns
and
skin
photosensitivity
.
In
all
,
14
patients
were
treated
at
the
MTD
without
significant
complications
.
Foscan-mediated
PDT
can
be
safely
combined
with
surgery
at
the
established
MTD
.
Unlike
most
other
surgery-based
multimodal
treatments
for
mesothelioma
,
Foscan-mediated
PDT
affords
the
option
,
in
selected
patients
,
of
accomplishing
tumor
debulking
with
a
lung
-sparing
procedure
rather
than
an
extrapleural
pneumonectomy
.
A
phase
II
study
is
warranted
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated