How to Avoid Local Side Effects of Bladder Photodynamic Therapy: Impact of the Fluence Rate
Abstract
PURPOSE: We studied how to avoid irritative bladder symptoms after bladder photodynamic therapy, such as urgency, frequency and pain, which are associated with the inflammation and destruction of normal urothelium. MATERIALS AND METHODS: Rats bearing orthotopic bladder tumors were instilled with hexyl-aminolevulinate and illuminated with red light at a high vs low (100 vs 15 mW/cm(2)) fluence rate. Cystectomy specimens 48 hours after treatment were subjected to anatomopathological examination. Inflammatory reaction and apoptosis were evaluated. In vivo photobleaching was assessed during illumination at each fluence rate. RESULTS: All superficial tumors were eradicated irrespective of light dose and fluence rate. High fluence rates induced necrosis with inflammatory reaction and absent normal urothelium. Low fluence rates did not provoke inflammation and resulted in apoptotic cell death with preserved urothelial integrity. This could be attributable to faster photobleaching of the photosensitizer in normal urothelium at low fluence rates. CONCLUSIONS: Bladder photodynamic therapy at a low fluence rate minimizes side effects without hampering therapeutic efficacy.
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Low-dose PDT often induces apoptosis and high-dose PDT typically results in necrosis.
“The dose of ALA and light as well as the light dose (fluence) rate may also determine how cells die of PDT, with low-dose PDT often inducing apoptosis and high-dose PDT typically resulting in necrosis [32,33].”
From 5-Aminolevulinic Acid as a Theranostic Agent for Tumor Fluorescence Imaging and Photodynamic Therapy (2023) · cites this paper as [33]
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References 23 · Cited by 23
- Authors
- François, A., Salvadori, A., Bressenot, A., Bezdetnaya, L., Guillemin, F., & D'Hallewin, M. A.
- Affiliations
- Centre National de la Recherche Scientifique (FR)
- Centre Alexis Vautrin, Centre Regional de Lutte Contre le Cancer, Vandœuvre-lès Nancy Cedex, France
- Inserm (FR)
- Université de Lorraine, Centre de Recherche en Automatique de Nancy, Unité Mixtes de Recherche 7039, Vandœuvre-lès Nancy Cedex, France
- ORCID
- Bezdetnaya, Lina
- Venue
- Journal of Urology
- Published
- 2013-08
- Volume
- 190
- Issue
- 2
- Pages
- 731-736
- ISSN
- 0022-5347 (ISSN-L)
- 1527-3792
- OpenAlex
- W2035573886
- Cited by
- 23
- References
- 23
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 1 · 2014: 3 · 2013: 1
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Urology (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Photodynamic Therapy Research Studies
- Health Sciences › Medicine › Surgery › Bladder and Urothelial Cancer Treatments
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- photodynamic therapy, bladder cancer, fluence rate, urothelium, apoptosis, necrosis, photobleaching, superficial bladder cancer, cystectomy, local adverse reactions
- MeSH terms
- Aminolevulinic Acid, Animals, Urinary Bladder Neoplasms, Female, Immunoenzyme Techniques, Photochemotherapy, Rats, Inbred F344, Spectrometry, Fluorescence, Tumor Cells, Cultured, Cystectomy, Apoptosis, Photosensitizing Agents, Rats
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