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Photodynamic therapy outcome modelling for patients with spinal metastases: a simulation-based study.
Yassine, Abdul-Amir; Lo, William C Y; Saeidi, Tina; Ferguson, Dallis; Whyne, Cari M; Akens, Margarete K; Betz, Vaughn; Lilge, Lothar.
Afiliación
  • Yassine AA; Edward S. Rogers Sr. Department of Electrical and Computer Engineering, University of Toronto, Toronto, ON, M5S 3G8, Canada. abed.yassine@mail.utoronto.ca.
  • Lo WCY; Harvard Medical School, Boston, MA, 02115, USA.
  • Saeidi T; Division of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, MA, 02142, USA.
  • Ferguson D; Department of Medical Biophysics, University of Toronto, Toronto, ON, M5G 1L7, Canada.
  • Whyne CM; Institute of Biomedical Engineering, University of Toronto, Toronto, ON, M5S 3G9, Canada.
  • Akens MK; Orthopaedic Biomechanics Laboratory, Sunnybrook Research Institute, Toronto, ON, M4N 3M5, Canada.
  • Betz V; Institute of Biomedical Engineering, University of Toronto, Toronto, ON, M5S 3G9, Canada.
  • Lilge L; Orthopaedic Biomechanics Laboratory, Sunnybrook Research Institute, Toronto, ON, M4N 3M5, Canada.
Sci Rep ; 11(1): 17871, 2021 09 09.
Article en En | MEDLINE | ID: mdl-34504208
Spinal metastases often occur in the advanced stages of breast, lung or prostate cancer, resulting in a significant impact on the patient's quality of life. Current treatment modalities for spinal metastases include both systemic and localized treatments that aim to decrease pain, improve mobility and structural stability, and control tumour growth. With the development of non-toxic photosensitizer drugs, photodynamic therapy (PDT) has shown promise as a minimally invasive non-thermal alternative in oncology, including for spinal metastases. To apply PDT to spinal metastases, predictive algorithms that optimize tumour treatment and minimize the risk of spinal cord damage are needed to assess the feasibility of the treatment and encourage a broad acceptance of PDT in clinical trials. This work presents a framework for PDT modelling and planning, and simulates the feasibility of using a BPD-MA mediated PDT to treat bone metastases at two different wavelengths (690 nm and 565 nm). An open-source software for PDT planning, PDT-SPACE, is used to evaluate different configurations of light diffusers (cut-end and cylindrical) fibres with optimized power allocation in order to minimize the damage to spinal cord or maximize tumour destruction. The work is simulated on three CT images of metastatically involved vertebrae acquired from three patients with spinal metastases secondary to colorectal or lung cancer. Simulation results show that PDT at a 565 nm wavelength has the ability to treat 90% of the metastatic lesion with less than 17% damage to the spinal cord. However, the energy required, and hence treatment time, to achieve this outcome with the 565 nm is infeasible. The energy required and treatment time for the longer wavelength of 690 nm is feasible ([Formula: see text] min), but treatment aimed at 90% of the metastatic lesion would severely damage the proximal spinal cord. PDT-SPACE provides a simulation platform that can be used to optimize PDT delivery in the metastatic spine. While this work serves as a prospective methodology to analyze the feasibility of PDT for tumour ablation in the spine, preclinical studies in an animal model are ongoing to elucidate the spinal cord damage extent as a function of PDT dose, and the resulting short and long term functional impairments. These will be required before there can be any consideration of clinical trials.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fotoquimioterapia / Neoplasias de la Columna Vertebral / Fármacos Fotosensibilizantes / Metástasis de la Neoplasia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Sci Rep Año: 2021 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fotoquimioterapia / Neoplasias de la Columna Vertebral / Fármacos Fotosensibilizantes / Metástasis de la Neoplasia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Sci Rep Año: 2021 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido