悪性グリオーマに対する第ニ世代光感受性物質Talaporfin sodiumを用いた蛍光診断ならびに光線力学的療法～臨床試から医師主導治験へ～

摘要

We employed second-generation photosensitizer, Talaporfin sodium, for the intra-operative photodynamic diagnosis (PDD) and photodynamic therapy (PDT) for glioblastoma patients. 22 consecutive patients with glioblastoma (16 newly diagnosed and 6 recurrence) received intravenous dosed of Talaporfin sodium (40 mg/m~2) 24 hours prior to craniotomy. Intra-operatively, tumor fluorescence was visualized using modified diode laser (664 nm) mounted surgical microscope. Fluorescence-guided resection of tumor tissue was performed, and additional PDT (150 mW/cm~2, 27 J/cm~2) was performed to 11 cases on invading tissues in eloquent area. A clear fluorescence signal was demonstrated in the tumor bulk and peritumoral zone, and the satisfactory resection of contrast-enhancing tumor was confirmed and achieved 9 months of median survival time. Mild liver dysfunction was occurred in 11.6% of cases, and skin photosensitivity was occurred in I case. The clinical experience in this study indicates the clinical feasibility of Talaporfin-induced PDD and PDT for glioblastoma patients.