Photodynamic therapy of intradermal metastatic breast cancer (literature review)

Abstract

In recent years, an increase in the incidence of breast cancer has been observed throughout the world, and in 20% of cases, with the development of intradermal metastases. The possibilities of surgical and radiation treatment of intradermal breast metastases are quite limited, and the effectiveness of polychemotherapy using standard regimens does not exceed 22–27%, while the period of remission, in general, is only 2–3 months. Photodynamic therapy (PDT) is a promising treatment for intradermal metastases of breast cancer. The experience of using PDT in this nosology is quite limited, but the results show its high efficiency and safety. Thus, several Russian studies are devoted to assessing the effectiveness of PDT of intradermal breast metastases with Photolon, a chlorin series photosensitizer. According to the authors, the therapeutic effect was achieved in 85–97% of patients (the percentage of patients with full and partial effect was 73–85%). Studies on the effectiveness of PDT in patients with the same nosology using the Photosens photosensitizer show a slightly lower effectiveness – the therapeutic effect was achieved in 81.8% of cases, while the proportion of patients with full and partial effect was only about 50%. Several studies have been carried out abroad on models of metastatic breast cancer using new photosensitizers (e.g. sodium sinoporphyrin) and new combined PDT regimens (e.g. adjuvant PDT with fluorouracil or Capecitabine). The obtained results demonstrate the promise of new approaches: PDT with sodium sinoporphyrin inhibited the growth of both the tumor itself and its metastases; the use of adjuvant regimens led to an increase in the tumor cells differentiation in the animal model, the cessation of tumor and metastatic foci growth.