Kt. Moesta et al., EVALUATING THE ROLE OF PHOTODYNAMIC THERAPY IN THE MANAGEMENT OF PANCREATIC-CANCER, Lasers in surgery and medicine, 16(1), 1995, pp. 84-92
Background and Objective: Cancer of the pancreas constitutes one of th
e major causes of cancer related death throughout the world. A 5-year
survival rate of only 2% and a maximum of 20 months median survival in
multi modality treatment studies dealing with the most favorable pati
ents only, has been demonstrated. This review analyzes the principal t
reatments and available experimental data in view of a clinical applic
ation of photodynamic therapy (PDT) for the treatment of pancreatic ca
ncer. Study Design/Materials and Methods: On the basis of published re
sults, we examined the palliation of pancreatic cancer by chemotherapy
alone; radiation alone and multimodality schedules (radiation and che
motherapy). Radical tumor resection was examined as attempted curative
treatment. Results: In reported therapeutic procedures, palliative or
potentially curative, median survival was below 2 years. The GTSG rep
orted survival time increases from 10.9 to 21.0 months when surgery is
followed by adjuvant chemotherapy and radiation. This combination pos
toperatively does not increase mortality, but adds 30% morbidity. Phot
odynamic therapy has been demonstrated in preclinical studies to have
a selective effect on malignant versus the normal pancreas. Conclusion
: PDT is highly effective in eliciting the destruction of experimental
pancreatic tumors with the lack of significant effect on the normal p
ancreas. The poor prognosis for patients with this disease, especially
those patients with advanced disease, warrants closer examination of
PDT for the treatment of pancreatic cancer. (C) 1995 Wiley-Liss, Inc.