PHOTODYNAMIC THERAPY FOR PENILE CARCINOMA

Abstract

Photodynamic therapy (PDT), using hematoporphyrin derivative (HpD) and red light (wavelength 630nm) of an argon-dye laser as the source of excitation energy was performed on 2 patients with non-invasive and papillary carcinoma of the penis and 2 patients with invasive penile carcinoma.
These histological diagnoses were squamous cell carcinoma. The 4 patients received PDT 72 to 96 hours after i. v. injection of 2 to 3mg/kg HpD.
Interstitial PDT was added to the 2 invasive carcinomas. The total light energy was adjusted to 60 to 300 Joules/cm². Tumor necrosis was observed 1 to 2 days after PDT, and tumor size was reduced rapidly thereafter.
Complete remission was obtained in the 2 papillary carcinoma patients.
One of the 2 patients is alive with no evidence of disease for 40 months to date. The other patient died of multiple bone and pulmonary metastases 9 months after PDT without local recurrence. In the 2 invasive carcinoma patients, a small amount of residual tumor cells invading to the corpus cavernosum was observed after PDT. They died of multiple metastases 11 and 2 months after PDT respectively.
Histopathological study of the tumor immediately after PDT showed a marked dilatation of the tumor vessels, bleeding in the stroma and degeneration of the nuclei of the endothelium. These findings suggested that vascular damage can be closely related to tumor destruction resulting from photodynamic effect.