Photodynamic-therapy-activated immune response against distant untreated tumours in recurrent angiosarcoma.

摘要

We report the case of a 64-year-old Chinese man with histologically proven multifocal angiosarcoma of the head and neck. To our knowledge, this was the first clinical case in which regression of untreated distant tumours was noted after photodynamic therapy. The patient was treated initially with high dose rate brachytherapy by use of an indium-192 (~(192)Ir) source for a total dose of 36 Gy over six fractions. The tumours showed regression, but recurred within 1 year. Further treatment options, including radiotherapy, surgery and photodynamic therapy, were discussed. The patient subsequently consented to photodynamic therapy, which was carried out in an outpatient clinic. We used a new generation photosensitiser, Fotolon (Haemato-science GmbH, Luckenwalde, Germany), which comprises chlorin e6 and polyvinylpyrrolidone (molecular weight 12 000) in the ratio of 1:1. Unlike first generation photosensitisers, which rendered patients light sensitive for up to a few weeks, Fotolon clears rapidly fromthe body within 24 h. Fotolon was prepared freshly by dissolving 0.2 g of Fotolon in 100 mL of 0.9% saline. The preparation was administered intravenously at a dose of 2.0-5.7 mg/kg body weight over 10-20 min. 3 h later, the tumours were irradiated with laser light of wavelength 665 nm (+- 3 nm) for a total light dose of 65-200 J/cm~2, delivered at a fluence rate of 80-150 mW/cm~2. The table shows the treatment parameters used during each administration.