4.4 Article

5-ALA photodynamic ablation of fibroblastic soft-tissue tumors

Journal

PHOTODIAGNOSIS AND PHOTODYNAMIC THERAPY
Volume 42, Issue -, Pages -

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ELSEVIER
DOI: 10.1016/j.pdpdt.2023.103624

Keywords

Fibroblastic tumors; 5-Aminolevulinic acid; Photodynamic therapy

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The use of 5-ALA photodynamic therapy can decrease the likelihood of local tumor recurrence in fibroblastic soft-tissue tumors.
Background: : Fibroblastic soft-tissue tumors share enzymatic anomalies that result in excessive intracellular conversion of 5-aminolevulinic acid (5-ALA) to protoporphyrin IX, a photosensitizer which induces cellular apoptosis upon exposure to visible red light at a wavelength of 635 nm. We hypothesized that red light illu-mination of the surgical bed remaining after resection of fibroblastic tumors will result in destruction of microscopic tumor residua and may decrease the likelihood of local tumor recurrence. Methods: : Twenty-four patients with desmoid tumors, solitary fibrous tumors (SFT), and dermatofibrosarcoma protuberans (DFSP) received oral 5-ALA prior to resection of their tumors. Following tumor resection, the exposed surgical bed was illuminated with red light at a wave length of 635 nm at a dose of 150 J/cm2 for 33 min.Results: : Treatment with 5-ALA was associated with minor side effects that included nausea and transient elevation of transaminases. Local tumor recurrence was detected in 1 of the 10 patients with desmoid tumors who had not undergone any previous surgery, none in the 6 patients who had SFT and 1 of the 5 patients who had DFSP.Conclusions: : 5-ALA photodynamic therapy of fibroblastic soft-tissue tumors may result in decreased likelihood of local tumor recurrence. It is associated with minimal side effects and should be considered as adjuvant to tumor resection in these cases.

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