Journal List > Korean J Obstet Gynecol > v.53(12) > 1006372

Korean J Obstet Gynecol. 2010 Dec;53(12):1092-1099. Korean.
Published online December 21, 2010.  https://doi.org/10.5468/kjog.2010.53.12.1092
Copyright © 2010 Korean Society of Obstetrics and Gynecology
Photodynamic therapy using topically applied 5-aminolevulinic acid for treatment of cervical cancer
Moon-Hee Youn, M.D.,1 Hyun-Chul Cho, M.D.,1 Jin-Chul Ahn, Ph.D.,2 Choong-Hak Park, M.D.,1 and Jin-Wan Park, M.D.1
1Department of Obstetrics and Gynecology, Dankook University College of Medicine, Cheonan, Korea.
2Medical Laser Research Center, Dankook University, Cheonan, Korea.

Corresponding author (Email: parkdkog@dankook.ac.kr )
Received February 19, 2008; Revised October 30, 2010; Accepted November 23, 2010.

Abstract

Objective

The purpose of this study was to investigate the treatment effects of a topical application of 5-aminolevulinic acid (5-ALA) for photodynamic therapy (PDT) to treat cervical cancer.

Methods

We first investigated the effects of 5-ALA cream according to application time. And to find the effective 5-ALA concentration and the distribution times in vivo, 20% 5-ALA cream was topically applied to the tumor of the nude mouse. We then observed the distribution of 5-ALA via fluorescence measurement with using a 532 nm diode laser. 25 nude mice were divided into Control, ALA, Laser, and PDT group. To evaluate the PDT effect at cancer lesion, we applied 20% 5-ALA cream to the tumor by the same method, and the PDT was done by using a 632 nm diode laser at the time of the peak level of fluorescence. We checked the changes of the volume of cancer for 30 days, and then biopsy was done.

Results

The effective post-irradiation time after topical ALA application was 9 hours. In the PDT group, 40% (4/10) of the mice showed decreased tumor size.

Conclusion

The maximum PpIX fluorescence at 9 hours after local applicationof 5-ALA cream was checked. And PDT group did not show any statistical difference than control group in the growth of tumor size than control group. However responding cases (4/10) of PDT group showed the meaningful decrease of tumor size than control group (P<0.05).

Keywords: Photodynamic therapy; 5-Aminolevulinic acid; Cervical cancer

Figures


 Fig. 1
The application of 5-aminolevulinic acid cream was occluded during the whole application period by covering the mouse all around with an adhesive dressing (A). The mice were given 480 J/cm2 of 632 nm diode laser on the skin overlying the tumor for 20 minutes (B). The tumor was recorded every 3 days after photodynamic therapy (PDT) (C: Before PDT, D: 9 days, E: 21 days, F: 30 days).
Click for larger image


Fig. 2
The effective 5-aminolevulinic acid distribution times were measured by the degree of fluorescence of PpIX with using a 532 nm diode laser. The .most effective distribution time after ALA injection was 9 hours.
Click for larger image


Fig. 3
Comparison of the tumor volume changes of the xenografted tumor of HeLa cancer cells in nude mouse according to four different groups. * Statistically significant difference between control and group IV respond group.
Click for larger image


Fig. 4
These pictures shows histological changes of xenografted tumor of HeLa cervical cancer cells in nude mouse at 30 days after photodynamic therapy in Group 4. The tumor size was decreased grossly, and there are small amounts of cancer tissue microscopically (H&E stain). Group 4 (partial remission): (A) ×40, (B) ×200.
Click for larger image

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