Interstitial Photodynamic Therapy for Glioblastomas: A Standardized Procedure for Clinical Use

Glioblastomas (GBMs) are high-grade malignancies with a poor prognosis. The current standard of care for GBM is maximal surgical resection followed by radiotherapy and chemotherapy. Despite all these treatments, the overall survival is still limited, with a median of 15 months. For patients harborin...

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Autores principales:	Henri-Arthur Leroy, Gregory Baert, Laura Guerin, Nadira Delhem, Serge Mordon, Nicolas Reyns, Anne-Sophie Vignion-Dewalle
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	interstitial photodynamic therapy glioblastoma brain tumor treatment planning system Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/7b11426700b94ed1964bb3d122a2aa1a
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spelling	oai:doaj.org-article:7b11426700b94ed1964bb3d122a2aa1a2021-11-25T17:03:37ZInterstitial Photodynamic Therapy for Glioblastomas: A Standardized Procedure for Clinical Use10.3390/cancers132257542072-6694https://doaj.org/article/7b11426700b94ed1964bb3d122a2aa1a2021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5754https://doaj.org/toc/2072-6694Glioblastomas (GBMs) are high-grade malignancies with a poor prognosis. The current standard of care for GBM is maximal surgical resection followed by radiotherapy and chemotherapy. Despite all these treatments, the overall survival is still limited, with a median of 15 months. For patients harboring inoperable GBM, due to the anatomical location of the tumor or poor general condition of the patient, the life expectancy is even worse. The challenge of managing GBM is therefore to improve the local control especially for non-surgical patients. Interstitial photodynamic therapy (iPDT) is a minimally invasive treatment relying on the interaction of light, a photosensitizer and oxygen. In the case of brain tumors, iPDT consists of introducing one or several optical fibers in the tumor area, without large craniotomy, to illuminate the photosensitized tumor cells. It induces necrosis and/or apoptosis of the tumor cells, and it can destruct the tumor vasculature and produces an acute inflammatory response that attracts leukocytes. Interstitial PDT has already been applied in the treatment of brain tumors with very promising results. However, no standardized procedure has emerged from previous studies. Herein, we propose a standardized and reproducible workflow for the clinical application of iPDT to GBM. This workflow, which involves intraoperative imaging, a dedicated treatment planning system (TPS) and robotic assistance for the implantation of stereotactic optical fibers, represents a key step in the deployment of iPDT for the treatment of GBM. This end-to-end procedure has been validated on a phantom in real operating room conditions. The thorough description of a fully integrated iPDT workflow is an essential step forward to a clinical trial to evaluate iPDT in the treatment of GBM.Henri-Arthur LeroyGregory BaertLaura GuerinNadira DelhemSerge MordonNicolas ReynsAnne-Sophie Vignion-DewalleMDPI AGarticleinterstitialphotodynamic therapyglioblastomabrain tumortreatment planning systemNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5754, p 5754 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	interstitial photodynamic therapy glioblastoma brain tumor treatment planning system Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	interstitial photodynamic therapy glioblastoma brain tumor treatment planning system Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Henri-Arthur Leroy Gregory Baert Laura Guerin Nadira Delhem Serge Mordon Nicolas Reyns Anne-Sophie Vignion-Dewalle Interstitial Photodynamic Therapy for Glioblastomas: A Standardized Procedure for Clinical Use
description	Glioblastomas (GBMs) are high-grade malignancies with a poor prognosis. The current standard of care for GBM is maximal surgical resection followed by radiotherapy and chemotherapy. Despite all these treatments, the overall survival is still limited, with a median of 15 months. For patients harboring inoperable GBM, due to the anatomical location of the tumor or poor general condition of the patient, the life expectancy is even worse. The challenge of managing GBM is therefore to improve the local control especially for non-surgical patients. Interstitial photodynamic therapy (iPDT) is a minimally invasive treatment relying on the interaction of light, a photosensitizer and oxygen. In the case of brain tumors, iPDT consists of introducing one or several optical fibers in the tumor area, without large craniotomy, to illuminate the photosensitized tumor cells. It induces necrosis and/or apoptosis of the tumor cells, and it can destruct the tumor vasculature and produces an acute inflammatory response that attracts leukocytes. Interstitial PDT has already been applied in the treatment of brain tumors with very promising results. However, no standardized procedure has emerged from previous studies. Herein, we propose a standardized and reproducible workflow for the clinical application of iPDT to GBM. This workflow, which involves intraoperative imaging, a dedicated treatment planning system (TPS) and robotic assistance for the implantation of stereotactic optical fibers, represents a key step in the deployment of iPDT for the treatment of GBM. This end-to-end procedure has been validated on a phantom in real operating room conditions. The thorough description of a fully integrated iPDT workflow is an essential step forward to a clinical trial to evaluate iPDT in the treatment of GBM.
format	article
author	Henri-Arthur Leroy Gregory Baert Laura Guerin Nadira Delhem Serge Mordon Nicolas Reyns Anne-Sophie Vignion-Dewalle
author_facet	Henri-Arthur Leroy Gregory Baert Laura Guerin Nadira Delhem Serge Mordon Nicolas Reyns Anne-Sophie Vignion-Dewalle
author_sort	Henri-Arthur Leroy
title	Interstitial Photodynamic Therapy for Glioblastomas: A Standardized Procedure for Clinical Use
title_short	Interstitial Photodynamic Therapy for Glioblastomas: A Standardized Procedure for Clinical Use
title_full	Interstitial Photodynamic Therapy for Glioblastomas: A Standardized Procedure for Clinical Use
title_fullStr	Interstitial Photodynamic Therapy for Glioblastomas: A Standardized Procedure for Clinical Use
title_full_unstemmed	Interstitial Photodynamic Therapy for Glioblastomas: A Standardized Procedure for Clinical Use
title_sort	interstitial photodynamic therapy for glioblastomas: a standardized procedure for clinical use
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/7b11426700b94ed1964bb3d122a2aa1a
work_keys_str_mv	AT henriarthurleroy interstitialphotodynamictherapyforglioblastomasastandardizedprocedureforclinicaluse AT gregorybaert interstitialphotodynamictherapyforglioblastomasastandardizedprocedureforclinicaluse AT lauraguerin interstitialphotodynamictherapyforglioblastomasastandardizedprocedureforclinicaluse AT nadiradelhem interstitialphotodynamictherapyforglioblastomasastandardizedprocedureforclinicaluse AT sergemordon interstitialphotodynamictherapyforglioblastomasastandardizedprocedureforclinicaluse AT nicolasreyns interstitialphotodynamictherapyforglioblastomasastandardizedprocedureforclinicaluse AT annesophievigniondewalle interstitialphotodynamictherapyforglioblastomasastandardizedprocedureforclinicaluse
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Interstitial Photodynamic Therapy for Glioblastomas: A Standardized Procedure for Clinical Use

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