A Quantitative Comparison of 5-Aminolaevulinic Acid- and Methyl Aminolevulinate-Induced Fluorescence, Photobleaching and Pain During Photodynamic Therapy

Ronan M. Valentine, Sally H. Ibbotson, C. Tom A. Brown, Kenny Wood, Harry Moseley

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    27 Citations (Scopus)

    Abstract

    The characteristics of protoporphyrin IX (PPIX) fluorescence in superficial basal cell carcinoma (sBCC) and carcinoma in situ (Bowen's Disease, BD) following application of 5-aminolaevulinic acid (5-ALA) and its methyl ester (methyl aminolevulinate [MAL]) before, during and after photodynamic therapy (PDT) were investigated in 40 patients. Photosensitizer prodrug penetration can limit PDT efficacy and understanding the characteristics of PPIX fluorescence through fluorescence spectroscopy, may improve knowledge of photosensitizer delivery. Fluorescence intensity was assessed quantitatively, and the rate of photobleaching was determined by fitting an exponential decay. As a secondary end-point, PDT-induced pain was also measured continuously during treatment using a novel hand-held device, known as a pain logger. In vivo PPIX fluorescence was shown to decrease during irradiation, allowing the in vivo photobleaching of PPIX to be monitored. No significant difference was found between ALA- or MAL-induced PPIX fluorescence in lesions of sBCC and BD (P > 0.05), indicating no detectable difference in PPIX kinetics for the two prodrugs as assessed by these measures. Pain, as assessed by the logger device, showed high interindividual variability and pain levels tended to be higher initially, decreasing during treatment. No difference was seen in pain experienced during ALA-or MAL-PDT (P > 0.05).

    Original languageEnglish
    Pages (from-to)242-249
    Number of pages8
    JournalPhotochemistry and Photobiology
    Volume87
    Issue number1
    DOIs
    Publication statusPublished - 2011

    Keywords

    • BASAL-CELL CARCINOMA
    • INDUCED PROTOPORPHYRIN-IX
    • NONMELANOMA SKIN-CANCER
    • ACTINIC KERATOSIS
    • PHOTOSENSITIZER FLUORESCENCE
    • TOPICAL APPLICATION
    • LIGHT
    • IRRADIANCE
    • GUIDELINES
    • DOSIMETRY

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