Abstract
Whole bladder wall photodynamic therapy (integral PDT), using hematoporphyrin derivative, red light (wavelength 630nm) emitted from an argondye laser and a newly designed light-scattering device, was carried out on VX2 carcinomas transplanted into the rabbit bladder wall. Definite necrotic change and vacuolar degeneration of the tumor cells were obtained with light energy of 20-50 Joules/cm2.
In a total of 12 patients with superficial multicentric bladder tumors with/ without carcinoma in situ, integral PDT was performed at the light energy of 10-30 Joules/cm2 except one patient. Clinical response was evaluated by selected-site mucosal biopsies and cystoscopic examination 4 weeks after treatment. Follow-up studies were made by urine cytology and cystoscopic examination for 14 months. Out of the 12 patients, 8 achieved complete response defined as no malignant cells in all the biopsies. Out of the 8 patients, 6 had not new ocurrence of bladder tumor with a mean tumor free time of 6 months. The newly designed device proved to be useful for integral PDT and the light dose of 10 to 20 Joules/cm2 may be sufficient to cure the CIS and very small flat tumor without severe damage of the normal wall.
