EARLY CLINICAL-EXPERIENCE WITH 5-AMINOLEVULINIC ACID FOR THE PHOTODYNAMIC THERAPY OF UPPER TRACT UROTHELIAL TUMORS

Purpose: Photodynamic therapy is effective in the treatment of superfi cial urothelial cancer of the bladder. We report our experience with p hotodynamic therapy for the treatment of upper urinary tract transitio nal cell carcinoma. Materials and Methods: Photodynamic therapy after oral administration of 5-aminolevulinic acid was performed in 4 patien ts with widespread superficial papillary tumors of the upper urinary t ract. Results: Complete remission occurred in 2 patients who remained free of local recurrence at 7 and 17 months of followup. In the other 2 patients residual tiny papillary tumors were found in the distal ure ter after photodynamic therapy. These tumors were coagulated with neod ymium: YAG laser irradiation. Both patients are disease-free at 24-mon th followup. Conclusions: Photodynamic therapy with 5-aminolevulinic a cid is a minimally invasive approach for organ preserving treatment of multifocal superficial transitional cell carcinoma of the upper urina ry tract.