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Phase I Study

William F. Sindelar, MD, PhD; Thomas F. DeLaney, MD; Zelig Tochner, MD; Gunter F. Thomas; Laura J. Dachoswki, RN; Paul D. Smith, PhD; Walter S. Friauf, MEE; John W. Cole, MSEE; Eli Glatstein, MD

Arch Surg. 1991;126(3):318-324.

Abstract
• Patients with disseminated intraperitoneal malignant neoplasms were given intra-abdominal photodynamic therapy. Patients received dihematoporphyrin ethers intravenously 48 to 72 hours before laparotomy at doses of 1.5 to 3.0 mg/kg. At operation, as much tumor as possible was resected. Red light (630 nm) was delivered to all peritoneal surfaces from an argon-pumped dye laser at doses ranging from 0.2 to 3.0 J/cm² in an escalating fashion. Viscera and peritoneal surfaces were anatomically isolated and exposed to light for intervals calculated to deliver the prescribed energy. Light was delivered to mesentery and bowel by a flat-cut optical fiber, while other areas, including diaphragm, viscera, omental bursa, gutters, and pelvis, were delivered light through a diffusing wand. Twenty-three patients (13 with ovarian cancer, eight with sarcoma, and two with pseudomyxoma peritoneii) underwent photodynamic therapy. Five of eight patients cleared positive peritoneal cytologies after treatment. Six patients remained clinically free of disease for up to 18 months, and five patients had treatment-related complications. Intraperitoneal phototherapy is technically feasible and deserving of clinical evaluation.

(Arch Surg. 1991;126:318-324)

Author Affiliations
From the Surgery Branch (Dr Sindelar) and the Radiation Oncology Branch (Drs DeLaney, Tochner, and Glatstein and Mr Thomas and Ms Dachowski), National Cancer Institute, and the Biomedical Engineering and Instrumentation Program (Dr Smith and Messrs Friauf and Cole), National Center for Research Resources, National Institutes of Health, Bethesda, Md.

Footnotes
Accepted for publication November 17, 1990.

Read before the 43rd Annual Cancer Symposium of the Society of Surgical Oncology, Washington, DC, May 20, 1990.

Reprint requests to the Surgery Branch, National Cancer Institute, National Institutes of Health, Bldg 10, Room 2B38, Bethesda, MD 20892 (Dr Sindelar).

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