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The aim of this study was to analyze the immediate and long-term results of using photodynamic therapy (PDT) in patients with leukoplakia of the oral mucosa. The retrospective study included 223 patients with morphologically verified leukoplakia of the oral mucosa. Patients received treatment at the hyperthermia and photodynamic therapy department from 2013 to 2023. The average age was 51.9±8.9 years. Clinically, 211 patients (94.6%) had a flat form of the disease, 12 patients (5.4%) had a verrucous form. The photosensitizer (PS), based on chlorin e6, was administered intravenously once in doses of 1.7 to 2.5 mg/kg body weight. Irradiation of pathologically changed lesions was carried out 2-2.5 hours after the end of its infusion, using a semiconductor laser device “UPL PDT”, with a wavelength λ=665±5 nm. The laser radiation dose density varied from 25 to 100 J/cm², the power density from 0.07 to 0.32 W/cm², the duration of one irradiation field - from 2 to 13.5 minutes, depending on its linear dimensions. The severity of adverse reactions was assessed on days 1-30 after treatment using the CTCAE 4.03 scale. The immediate results of treatment were assessed up to 3 months after PDT, with morphological confirmation of the response to treatment. No serious adverse reactions were observed during PS infusion and irradiation. No symptoms of dermal phototoxicity were reported. During control examinations, up to 3 months after irradiation in patients with flat and verrucous forms, the frequency of complete regressions was 97.1% (n=205) and 58.3% (n=6) cases, partial regressions - 2,9% (n=7) and 25% (n=3) of cases, respectively. Objective response rates were observed at 100% and 83.3%, respectively. The period of observation of patients varies from 3 to 120 months. (average 66 months). The frequency of disease relapses during this period was 9%. Patients with partial regression and identified relapse were treated with repeated PDT sessions. PDT is a well-tolerated and effective treatment method for patients with leukoplakia of the oral mucosa, which has significant advantages over traditional methods of treating this precancerous pathology. These include minimal toxicity to the normal tissues surrounding the pathological foci due to the selective accumulation of PS in leukoplakia tissues, a slight risk of serious adverse reactions, the possibility of an outpatient session, the possibility of repeated treatment over a large area of damage and good cosmetic results).

A significant therapeutic effect of photodynamic therapy (PDT) is shown in a patient with extensive vulvar cancer after ineffective surgical and chemoradiotherapy. During the year, three courses of local PDT with a photosensitizer based on chlorin e6 were carried out. The photosensitizer was administered intravenously three hours before irradiation at a dose of 1.2 mg/kg. For laser irradiation (662 nm) of the vulvar tumor, a light guide for external irradiation was used: the power density was 0.2 W/cm2, the light dose was from 100 to 250 J/cm2. As a result of treatment, tumor regression and stable remission are observed. The patient remains under observation.

Photodynamic therapy (PDT) is one of the most effective treatments for basal cell skin cancer (BCC). As the incidence rate of BCC is increasing worldwide, interest in developing new methods for diagnosing and treating this disease, taking into account long-term cosmetic results, is growing. The review article presents the results of domestic and foreign studies on the treatment of BCC with PDT. The presented results of studies from various domestic and foreign clinics indicate the high efficiency of independent PDT and a combination of PDT with other treatment methods. PDT is proposed to be used in combination with surgical methods and radiation therapy, immunomodulating and chemotherapeutic agents, and inhibitors of molecules involved in the carcinogenic process. These new strategies open the way to increasing the effectiveness of treatment and prevention of BCC. Moreover, in all studies, the safety of this non-invasive treatment, a low level of adverse reactions during therapy, good tolerance for the patient and excellent cosmetic treatment results are noted. The guidelines currently being developed in Europe and the United States provide consistent expert advice that reflects current published evidence of treatment outcomes for BCC using PDT. Moreover, the recommendations emphasize that the treatment plan for patients with “difficult to treat” BCC should be discussed at an interdisciplinary oncological council.

Background. Photodynamic therapy of acute cholangitis involves the introduction of a photosensitizer into the common bile duct and subsequent laser irradiation of the liver. The study of combined laser action on the liver is promising. Purpose of the study. To evaluate in an experiment the effectiveness of photodynamic therapy of acute cholangitis with the introduction of a photosensitizer into the common bile duct and combined laser irradiation of the liver. Material and methods. Acute cholangitis was modeled in rabbits. In the first group, a saline solution was introduced into the common bile duct, in the second and third – "Photolon". Then, in the second group, photodynamic therapy with endocholedocheal laser irradiation of the liver was performed, in the third group – with combined irradiation. The general condition of the animals, their laboratory, microscopic and microbiological parameters were evaluated. After the autopsy, a histological examination of the liver and common bile duct was performed. Results. On the 2nd day of the experiment, all rabbits developed acute cholangitis. After treatment in the group "Experience 3", in comparison with other groups, there was a greater decrease in the indicators of inflammation and cholestasis in the blood, the number of microorganisms and white blood cells in the bile. In the first group, the formation of liver abscesses was histologically noted. Pathological changes in the wall of the common bile duct and liver in the third group were less pronounced than in the second. Conclusions. 1. The experimental model allows on the second day to reproduce acute cholangitis in rabbits. 2. Photodynamic therapy with Photolon photosensitizer with combined (endocholedocheal and surface) laser irradiation of the liver has a more pronounced bactericidal effect compared to endocholedocheal irradiation.

Background. Malignant tumors management using conventional treatment modalities is associated with poor outcomes. Objective of the study. To assess photodynamic activity of Photolon as monotherapy, as well as in combination with radio- and chemotherapy in an experiment. Material and methods. The research was done on HeLa monolayer culture (human uterine cervix carcinoma), 97 white random-bred rats with Pliss lymphosarcoma and 42 mice (CBA) with uterine cervix cancer-5 (UCC-5). Results. The amplification factor in Photolon photoirradiation was 65.1 in terms of the cytostatic effect and 98.5 in terms of cytotoxic effect. Photodynamic therapy enhances the efficacy of radiotherapy, since it reduced Pliss lymphosarcoma growth rate in rats down to 33.7% and UCC-5 growth rate in mice down to 14.9% of the intact control level (p

The aim of study is to evaluate the tolerability and effectiveness of photodynamic therapy as an organ‑preserving treatment in patients with vulvar leukoplakia. 50 patients with a verifed diagnosis of «vulvar leukoplakia» were included in the study. The age varied from 27 to 74 years. The method of treatment assumed the use of the photosensitizer рhotolon (RUE «Belmedpreparaty», Belarus) administered intravenously in doses of 1.8–2.5 mg/kg. Photoirradiation of pathological foci was carried out 2.5–3 hours after intravenous injection of photolon® using a semiconductor laser «UPL PDT» (LEMT, Belarus, λ=661 nm) at exposure doses from 30 to 100 J/cm2 with a power density of 100–170 mW/cm2. The treatment was performed under medical anesthesia. The results of treatment were evaluated using clinical data. Adverse reactions and complications after the introduction of the photosensitizer and photoirradiation have not been observed. Complete clinical regression of the treated pathological foci was noted in 100% of cases with a follow‑up observation 1 month after the treatment. At follow‑up after 3 months, local recurrences of the disease were detected in 4 cases, which were successfully treated with repeated photo‑dynamic therapy sessions. The percentage of complete regressions was 92%, partial – 8%. The obtained results allow judging on the possibility of using photodynamic therapy in the treatment of patients with vulvar leukoplakia, which allows to preserve the organ and obtain a satisfactory functional and cosmetic result.

The article shows possibilities in fluorescence imaging of malignant skin tumors with chlorin series photosensitizers (PS) photolon and fotoditazin. The regularities of photosensitizer accumulation from the data of local fluorescence spectroscopy depending on the PS and its dose, the clinical picture and the histological form of the malignant skin neoplasm is investigated. It is shown that the level and selectivity of PS accumulation in the tumor focus depends on the PS dose. In studies on 10 patients with basal cell skin cancer after the introduction of fotoditazin at a dose less than 1 mg/kg, fluorescent contrast between tumor and healthy tissue varied between 1.3 and 9.5, the average was 2.8±0.3; for patients who had the administered fotoditazin dose of 1 mg/kg, fluorescent contrast was 2.9±0.4, varying from 1.4 to 5. In a study with 127 patients after the introduction of photolon in the dose of 0.7-1 mg/kg, the average value of the fluorescence intensity in relative units in the intact skin was 6.9±0.3 (min 4.6, max 12.2), at a dose of 1.1 to 1.4 mg/kg – 8.0±0.3 (min 4.6, max 12.5), at a dose of 1.5-2 mg/kg – 9.9±0.7 (min 5.7, max 20.3). It is also shown that fluorescence intensity of malignant neoplasm of the skin with the same dose of the photosensitizer depends on the neoplasm’s clinical and histological forms. So, 3 hours after the introduction of photolon at a dose of 1.3 mg/kg the average fluorescent contrast in the surface type of skin cancer was 2.7±0.5, in the nodal form – 2.3±0.2, in erosive-ulcerative form – 3.6±0.3. In patients with nodular form of squamous skin cancer after the introduction of photolon at a dose of 1.3 mg/kg fluorescent contrast was significantly higher (p

The article is devoted to the development and evaluation of the effi ciency of photodynamic therapy (PDT) with photosensitizer photolon with additional interstitial laser irradiation in patients with head and neck basal cell skin cancer (BCSC). Treatment was performed in 55 patients. On the fi rst stage, all patients underwent photodynamic therapy with interstitial irradiation using fl exible optical fi bers with cylindrical diffuser, on the second stage PDT with distant delivery of laser at a dose of 50-300 J/cm2 was carried out. During the follow- up period of 6 months to 4 years in 13 (23.6%) of the 55 patients a recurrence of the disease was diagnosed. A higher rate of recurrence was in the group of patients who underwent PDT for recurrent neoplasms compared with patients with primary disease (37.5% and 4.3%, respectively), in patients with endophytic growth of the tumor compared to patients with exophytic component (30.0% and 16.0%,respectively) and in patients with large tumors (up to 2.0 cm – 14.3%, from 2.0 to 5.0 cm – 16.7% and more than 5.0 cm – 54.4%).

The short-term and long-term outcomes of treatment in 130 patients with basal cell carcinoma (T1N0M0, I stage) using photodynamic therapy with photosensitizer photolon based on chlorine e6 are represented in the article. The session of photodynamic therapy was performed 2.5-3 h after intravenous injection of photolon at dose of 2-2.5 mg/kg using semiconductor laser (λ=660±5 nm, laser power density — from 0.1 to 0.52 W/cm2, light dose — from 50 to 300 J/cm2). Complete regression of primary and recurrent carcinomas was observed in 90.9% and 88.9% of patients, respectively. For follow-up period of 3 to 76 months the local recurrence of the tumor was in detected in 6.9% of cases. Patients, who followed the light regimen for 2–3 days after photolon administration avoiding direct sun light exposure, had no manifestation of phototoxicity. Ten patients who failed to follow the light regimen had mild hyperemia, itching and burning in the exposed skin area selflimiting in several hours. Cosmetic results of photodynamic therapy with photolon are superior to those for traditional treatment methods for this disease.

The new method of photodynamic therapy for basal cell skin carcinoma with intralesional injection of photolon (at dose of 1.44-2.50 mg/cm3 of tumor volume 15 min before irradiation) was developed in the department of dermatology, venerology and dermatooncology in The State Budgetary Healthcare Institution of Moscow Area Moscows regional research clinical institute n.a. M.F. Vladimirskiy. The efficacy of the developed method was evaluated in clinical studies in 30 patients comparing with the group of 32 patients who had conventional PDT with typical intravenous injection of photolon (at dose of 2.0–2.5 mg/kg of body weight 3 h before irradiation). The characteristics of irradiation were the same both in the study and in the control groups: power density of 0.31-0.47 W/cm2, light dose of 300 J/cm2. Compared PDT regimens had similar efficiency. As a result of the performed treatment complete tumor regression was achieved in 93.3% patients with intralesional injection of photolon and in 90.6% patients with intravenous injection. The rate of patients with 2-year recurrence-free survival after intralesional injection of photolon accounted for 96.7%; after intravenous injection – 93.8%. However, the developed method demonstrated superior safety comparing with intravenous injection of photolon: such as there was no need for light regimen after intralesional injection of photolon, there were no cases of skin phototoxicity (12.5% for intravenous injection), no increasing of transaminases (37.5% for intravenous injection).

The results of photodynamic therapy (PDT) in 76 patients with tumors of different sites and with regional or distant metastases are represented. Sixty three patients were under combined or multimodal therapy, 13 patients had systemic PDT as monotherapy. The technique of PDT was as follows: the solution of photosensitizer photolon was administered intravenously at dose of 0.8–1.4 mg/ kg body weight. Laser blood irradiation was performed simultaneously (wavelength of 662 nm, output power of 20 mW, irradiation time of 50 min). Stabilization of the disease defined as the absence of new tumor foci was observed in 55% of treated patients: among them in 47% of patients with disseminated melanoma during 6–10 months after treatment, in 65% patients with breast cancer – for 3–6 years after treatment, and also in 100% of patients with cancer of other sites (colorectal, pancreatic, cervical, ovarian, lung and stomach cancer, retroperitoneal neuroblastoma) – for 10–12 months after treatment. According to ultrasound data the shrinkage of most of metastases up to its complete disappearance was observed. The authors consider that effects of systemic PDT are due to decrease of circulating tumor cells in blood and also due to beneficial impact of this modal of treatment on immune status of cancer patient. Intravenous PDT was shown to improve treatment results and quality of life in patients with metastases of malignant tumors. The approved technique is of considerable interest and requires further investigation of its efficiency including its combination with methods of combined and multimodal treatment.

This article is dedicated to clinical experience of photodynamic therapy (PDT) in Medical Radiological Research Center. Authors represent the results of treatment in 156 patients with primary untreated tumors of different localizations as follows: basal cell skin cancer (BCSC) in 156 patients, squamous cell carcinoma of the skin (SCCS) in 24 patients, cancer of upper and lower lips in 30 patients. The other group of patients included recurrent and metastatic diseases: recurrent BCSC were in 127 patients, recurrent or continued growth of SCCS – in 27, recurrent or continued growth of lip cancer – in 13, intracutaneous metastases of skin melanoma (62 patients) and breast cancer (46) – in 108. PDT was performed with photosensitizers Photosense (2.0 mg/kg), Photolon (0.9–2.5 mg/kg), and Photoditazine (0.7–0.8 mg/kg). The light irradiation dose was 100–600 J/cm2. After PDT of previously untreated BCSC the complete regression (CR) of tumor lesions was in 96.8% of patients, partial regression (PR) – in 3.2% of patients; for PDT of recurrent BCSC in 76.4% and 23.6%, respectively. After PDT treatment in patients with previously untreated SCCS CR of tumor lesions was achieved in 91.7% of patients, PR – in 8.3% of patients. For treatment of relapses in SCCS CR was achieved in 59.3% of cases, PR – in 33.3%, absence of regression was reported in 7.4% of cases. PDT of intracutaneous metastases of skin melanoma and breast cancer provided positive treatment effect (CR + PR + stabilizing) in 95 and 98% of cases, respectively. CR in primary lip cancer after PDT was reported in 86.0% of patients, PR – in 14.0%. For PDT of recurrent lip cancer CR accounted for 69.2%, PR – 30.8%.

A case of successful photodynamic therapy (PDT) of the patient with grade 3 vulvar dysplasia. One course of treatment with photolon was performed. The photosensitizer was administered intravenously as 30 min infusion in dose of 1.0 mg/kg body weight. The PDT session was performed 3h after infusion of photolon, the light dose was 350 J/cm2. The treatment was well tolerated. Due to PDT a complete tumor regression was achieved. The patient received a strict follow-up schedule, for 8 months after PDT no recurrence was observed.

A case of successful photodynamic therapy in patient of 86 y.o. with diagnosis: angiosarcoma of right temporal-parietal region stage IIA (Т2вN0M0) is reported. The tumor was as soft tissue round shape lesion with tuberous contours 3.4х3.4х1.1 cm in size, located in subcutaneous tissue in right parietal region with no scull bone invasion. The patient was refused to surgical treatment with general anesthesia due to severe cardiovascular co-morbidity. The patient underwent a course of photodynamic therapy with Photolon. The photosensitizer was intravenousely introduced for 3 h before irradiation at dose of 1 mg/kg body weight. The parameters of irradiation were as follows: output power – 0.8 W, light dose – 150 J/cm2, 4 irradiation fields 2.5 cm in diameter. During the irradiation there were moderate pain which did not require drug management. After PDT complete regression of the tumor was achieved. For nowadays (11 months after treatment) the patient is observed with no recurrence. The reported case shows that photodynamic therapy may be successfully used for alternative treatment of soft tissue angiosarcoma in patients with no ability for surgical treatment.

Results of treatment for cutaneous metastasis of breast cancer with photjdynamic therapy are represented. The study included 46 patients, the total number of treated cutaneous metastases was 535. For photodynamic therapy photosensitizer photolon given intravenously at a dose of 0.9–1.6 mg/kg body weight 3 h before treatment session (wave length 661±1 nm, плотность мощности 0,11–0,56 J/cm2), мощность на выходе волокна 0,3–2,0 Wt, light dose 50–600 J/cm2. Complete regression of metastasis was obtained in 33.6% of cases, partial – in 39.4%, stabilization – in 22.6%, progression of disease was in 4.3% of cases. The results show the perspectiveness of photodynamic therapy for metastasis as one of the step of treatment.

The results of treatment of the patient with verrucous luekoplakia of mucous membrane of body of the tongue with photodynamic therapy are represented. In 2015 the patient underwent 4 courses of photodynamic therapy with photosensitizer photolon. Photolon was injected at dose of 2 mg/kg 3 h before irradiation (laser output power was 0.262 W, light dose – 50 and 100 J/cm2). The result of treatment was assessed as complete regression: 4 months after multiple-course photodynamic therapy there were no clinical and histological signs of luekoplakia.