Regression Analysis of Protoporphyrin IX Measurements Obtained During Dermatological Photodynamic Therapy

Photodynamic therapy (PDT) is a light activated drug therapy that can be used to treat a number of dermatological cancers and precancers. Improvement of efficacy is required to widen its application. Clinical protoporphyrin IX (PpIX) fluorescence data were obtained using a pre-validated, non-invasiv...

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Main Authors: Jessica Tyrrell, Cheryl Paterson, Alison Curnow
Format: Article
Language:English
Published: MDPI AG 2019-01-01
Series:Cancers
Subjects:
Online Access:http://www.mdpi.com/2072-6694/11/1/72
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author Jessica Tyrrell
Cheryl Paterson
Alison Curnow
author_facet Jessica Tyrrell
Cheryl Paterson
Alison Curnow
author_sort Jessica Tyrrell
collection DOAJ
description Photodynamic therapy (PDT) is a light activated drug therapy that can be used to treat a number of dermatological cancers and precancers. Improvement of efficacy is required to widen its application. Clinical protoporphyrin IX (PpIX) fluorescence data were obtained using a pre-validated, non-invasive imaging system during routine methyl aminolevulinate (MAL)-PDT treatment of 172 patients with licensed dermatological indications (37.2% actinic keratosis, 27.3% superficial basal cell carcinoma and 35.5% Bowen’s disease). Linear and logistic regressions were employed to model any relationships between variables that may have affected PpIX accumulation and/or PpIX photobleaching during irradiation and thus clinical outcome at three months. Patient age was found to be associated with lower PpIX accumulation/photobleaching, however only a reduction in PpIX photobleaching appeared to consistently adversely affect treatment efficacy. Clinical clearance was reduced in lesions located on the limbs, hands and feet with lower PpIX accumulation and subsequent photobleaching adversely affecting the outcome achieved. If air cooling pain relief was employed during light irradiation, PpIX photobleaching was lower and this resulted in an approximate three-fold reduction in the likelihood of achieving clinical clearance. PpIX photobleaching during the first treatment was concluded to be an excellent predictor of clinical outcome across all lesion types.
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spelling doaj.art-b8aea0a02e7b49da99130ca99ff370bf2023-09-02T23:51:59ZengMDPI AGCancers2072-66942019-01-011117210.3390/cancers11010072cancers11010072Regression Analysis of Protoporphyrin IX Measurements Obtained During Dermatological Photodynamic TherapyJessica Tyrrell0Cheryl Paterson1Alison Curnow2European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UKEuropean Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UKEuropean Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, UKPhotodynamic therapy (PDT) is a light activated drug therapy that can be used to treat a number of dermatological cancers and precancers. Improvement of efficacy is required to widen its application. Clinical protoporphyrin IX (PpIX) fluorescence data were obtained using a pre-validated, non-invasive imaging system during routine methyl aminolevulinate (MAL)-PDT treatment of 172 patients with licensed dermatological indications (37.2% actinic keratosis, 27.3% superficial basal cell carcinoma and 35.5% Bowen’s disease). Linear and logistic regressions were employed to model any relationships between variables that may have affected PpIX accumulation and/or PpIX photobleaching during irradiation and thus clinical outcome at three months. Patient age was found to be associated with lower PpIX accumulation/photobleaching, however only a reduction in PpIX photobleaching appeared to consistently adversely affect treatment efficacy. Clinical clearance was reduced in lesions located on the limbs, hands and feet with lower PpIX accumulation and subsequent photobleaching adversely affecting the outcome achieved. If air cooling pain relief was employed during light irradiation, PpIX photobleaching was lower and this resulted in an approximate three-fold reduction in the likelihood of achieving clinical clearance. PpIX photobleaching during the first treatment was concluded to be an excellent predictor of clinical outcome across all lesion types.http://www.mdpi.com/2072-6694/11/1/72aminolevulinic acid (ALAAmeluz)dermatologyfluorescenceimagingmethyl aminolevulinate (MALMetvix)non-melanoma skin cancer (NMSC)photobleachingphotodynamic therapy (PDT)protoporphyrin IX (PpIX)
spellingShingle Jessica Tyrrell
Cheryl Paterson
Alison Curnow
Regression Analysis of Protoporphyrin IX Measurements Obtained During Dermatological Photodynamic Therapy
Cancers
aminolevulinic acid (ALA
Ameluz)
dermatology
fluorescence
imaging
methyl aminolevulinate (MAL
Metvix)
non-melanoma skin cancer (NMSC)
photobleaching
photodynamic therapy (PDT)
protoporphyrin IX (PpIX)
title Regression Analysis of Protoporphyrin IX Measurements Obtained During Dermatological Photodynamic Therapy
title_full Regression Analysis of Protoporphyrin IX Measurements Obtained During Dermatological Photodynamic Therapy
title_fullStr Regression Analysis of Protoporphyrin IX Measurements Obtained During Dermatological Photodynamic Therapy
title_full_unstemmed Regression Analysis of Protoporphyrin IX Measurements Obtained During Dermatological Photodynamic Therapy
title_short Regression Analysis of Protoporphyrin IX Measurements Obtained During Dermatological Photodynamic Therapy
title_sort regression analysis of protoporphyrin ix measurements obtained during dermatological photodynamic therapy
topic aminolevulinic acid (ALA
Ameluz)
dermatology
fluorescence
imaging
methyl aminolevulinate (MAL
Metvix)
non-melanoma skin cancer (NMSC)
photobleaching
photodynamic therapy (PDT)
protoporphyrin IX (PpIX)
url http://www.mdpi.com/2072-6694/11/1/72
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AT cherylpaterson regressionanalysisofprotoporphyrinixmeasurementsobtainedduringdermatologicalphotodynamictherapy
AT alisoncurnow regressionanalysisofprotoporphyrinixmeasurementsobtainedduringdermatologicalphotodynamictherapy