CLINICAL EXPERIENCE WITH 5-AMINOLEVULINIC ACID AND PHOTODYNAMIC THERAPY FOR REFRACTORY SUPERFICIAL BLADDER CANCER

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jun 2001CLINICAL EXPERIENCE WITH 5-AMINOLEVULINIC ACID AND PHOTODYNAMIC THERAPY FOR REFRACTORY SUPERFICIAL BLADDER CANCER RAPHAELA WAIDELICH, HERBERT STEPP, REINHOLD BAUMGARTNER, ERNST WENINGER, ALFONS HOFSTETTER, and MARTIN KRIEGMAIR RAPHAELA WAIDELICHRAPHAELA WAIDELICH , HERBERT STEPPHERBERT STEPP , REINHOLD BAUMGARTNERREINHOLD BAUMGARTNER , ERNST WENINGERERNST WENINGER , ALFONS HOFSTETTERALFONS HOFSTETTER , and MARTIN KRIEGMAIRMARTIN KRIEGMAIR View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66239-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined whether photodynamic therapy after the oral administration of 5-aminolevulinic acid in patients with superficial bladder cancer that cannot be controlled by transurethral resection and intravesical bacillus Calmette-Guerin (BCG) immunotherapy would preserve the bladder, while stopping tumor progression. Side effects of treatment were also assessed. Materials and Methods: We performed photodynamic therapy after the oral administration of 5-aminolevulinic acid in 24 patients with rapidly recurring, multifocal, BCG refractory superficial pTa-pT1 transitional cell carcinoma of the bladder and carcinoma in situ. Results: At a median followup of 36 months (range 12 to 51) 3 of the 5 patients with carcinoma in situ and 4 of the 19 with papillary tumors were free of recurrence. Three patients were rendered disease-free by repeat photodynamic therapy with 5-aminolevulinic acid and 3 underwent cystectomy. Tumor progression was stopped in 20 of our 24 cases. Immediately after the oral administration of 5-aminolevulinic acid hypotension and tachycardia occurred in 19 and 10 patients, respectively, with previously known severe cardiovascular disease. No phototoxic skin reaction or decreased bladder capacity was observed. Conclusions: These initial clinical results suggest that photodynamic therapy with orally administered 5-aminolevulinic acid is effective as an organ preserving procedure for treating superficial bladder cancer even in patients with bacillus Calmette-Guerin refractory carcinoma. One should be aware of hemodynamic instability after the oral administration of 5-aminolevulinic acid, particularly in patients with cardiovascular co-morbidity. References 1 : Report of a follow-up of papillary tumours of the bladder. Br J Urol1964; 36: 14. Google Scholar 2 : Bladder cancer clinical guidelines panel summary report on the management of nonmuscle invasive bladder cancer (stages Ta, T1 and TIS). J Urol1999; 162: 1697. Link, Google Scholar 3 : Bacillus Calmette-Guerin for treatment of superficial transitional cell carcinoma of the bladder in patients who have failed thiotepa and/or mitomycin C. J Urol1987; 137: 871. Link, Google Scholar 4 : When intravesical measures fail. 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Google Scholar From the Departments of Urology and Anesthesiology, University of Munich, Munich, Germany© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byNazmifar M, Williams C, Naser-Tavakolian A, Heard J, Rosser C, Theodorescu D and Ahdoot M (2022) Clinical and Preclinical Therapies for Bladder Cancer Following Bacillus Calmette-Guérin FailureJournal of Urology, VOL. 209, NO. 1, (32-48), Online publication date: 1-Jan-2023.ASANUMA H, ARAI T, MORIMOTO Y, KAWAUCHI S, SATOH H, SEGUCHI K, KIKUCHI M and MURAI M (2018) PHOTODYNAMIC THERAPY WITH PAD-S31, A NEW HYDROPHILIC CHLORIN PHOTOSENSITIZER, IN AN ORTHOTOPIC RAT BLADDER TUMOR MODELJournal of Urology, VOL. 174, NO. 5, (2016-2021), Online publication date: 1-Nov-2005.HERR H and DALBAGNI G (2018) Defining Bacillus Calmette-Guerin Refractory Superficial Bladder TumorsJournal of Urology, VOL. 169, NO. 5, (1706-1708), Online publication date: 1-May-2003.XIAO Z, BROWN K, TULIP J and MOORE R (2018) Whole Bladder Photodynamic Therapy for Orthotopic Superficial Bladder Cancer in Rats: A Study of Intravenous and Intravesical Administration of PhotosensitizersJournal of Urology, VOL. 169, NO. 1, (352-356), Online publication date: 1-Jan-2003. Volume 165 Issue 6 Part 1 June 2001 Page: 1904-1907 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsbladdercarcinoma, transitional cellphotochemotherapyaminolevulinic acidMetrics Author Information RAPHAELA WAIDELICH More articles by this author HERBERT STEPP More articles by this author REINHOLD BAUMGARTNER More articles by this author ERNST WENINGER More articles by this author ALFONS HOFSTETTER More articles by this author MARTIN KRIEGMAIR More articles by this author Expand All Advertisement PDF downloadLoading ...