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 V
X2 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/cm
2.
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/cm
2 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.
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