Interstitial photodynamic therapy in the Dunning R3327-AT6 prostatic carcinoma

Interstitial photodynamic therapy (PDT) could be an alternative radical treatment for prostate cancer. The ability to predict the depth of necrosis is necessary for light treatment planning using multiple optical fibres. The extent of PDT necrosis was studied in subcutaneously implanted R3327-AT6 Dunning prostate tumours which had similar optical characteristics to human prostate. Tumour-bearing subjects were given 20 mg kg(-1) Haematoporphyrin esters (HPE) and irradiated 24h later with 630 nm laser light. Five subjects per group were treated with increasing light doses (50-450 J cm(-1)) delivered interstitially via a single 2 cm long cylindrical diffuser. After 450 J cm(-1) of irradiation, 4.3 +/- 0.8 cm(3) [standard error of the mean (s.e.m.)] of tumour tissue was necrosed to a depth of 10.5 +/- 0.8 mm around the diffuser. There was an approximately linear correlation between the volume of PDT necrosis around the fibre and prescribed light dose. The mean threshold light dose for PDT effect was 18 +/- 2 J cm(-2). In this tumour with a mean photosensitizer concentration of 16 +/- 1.5 mu g g(-1), low light doses produced tumour necrosis. PDT using multiple diffusers could destroy a relatively large tumour volume and the 'diffusion theory' model reliably predicted the depth of necrosis.