Treatment of cervix carcinoma FIGO IIIb with Photofrin II as a radiosensitizer: a case report.

Abstract

Cervical cancer is the fourth-most common type of cancer and cause of death in women. Human papilloma virus (HPV) infection is responsible for over 90% of cervical cancers. The recommended treatment is multidisciplinary, consisting of a combination of surgery, chemotherapy, and radiation therapy. The standard treatment in advanced stages, such as FIGO IIIb, is radio-chemotherapy with overall 5-year survival of 32%. Photofrin II has been demonstrated to serve as a specific and selective radiosensitizing agent in both in vitro and in vivo tumor models, admitted for radiation therapy. We describe a patient with advanced cervical carcinoma (squamous cell) who contacted us for further therapy in 2003. Staging included a gynecological examination, colonoscopy, explorative laparotomy, biopsy and pelvic MRI. The explorative laparotomy showed enlarged pelvic and para-aortal lymph nodes. The histologic examination described tumor infiltrated, positive lymph nodes (Stage FIGO IIIb). Contrary to recommendations, the patient refused standard treatment with a combination of chemotherapy and radiotherapy, but accepted a combined treatment of Photofrin II as a radiosensitizer and a radiotherapy procedure. She underwent irradiation with a 50.4 + 14 Gy boost with fractionation of 1.8 Gy day-1 for 5 days per week; the boost was given with 2 Gy fractions. She was injected with a single intravenous dose in a slow infusion (30 min) of 1 mg kg-1 of Photofrin II 24 h prior to radiation therapy. A localized relapse in the cervix appeared after 30 months, and was resected by hysterectomy. The patient is still alive with no evidence of disease after 15 years.

• Authors: Pamela Schaffer , Ron Batash , Birgit Ertl-Wagner , Alfons Hofstetter , Noam Asna , Moshe Schaffer
• Journal: Photochemical & photobiological sciences : Official journal of the European Photochemistry Association and the European Society for Photobiology (Photochem Photobiol Sci) Vol. 18 Issue 5 Pg. 1275-1279 (May 15 2019) ISSN: 1474-9092 [Electronic] England
• PMID: 30892313 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Radiation-Sensitizing Agents
• Dihematoporphyrin Ether

Topics

• Antineoplastic Agents (therapeutic use)
• Carcinoma (drug therapy, pathology)
• Combined Modality Therapy
• Dihematoporphyrin Ether (therapeutic use)
• Female
• Humans
• Magnetic Resonance Imaging
• Middle Aged
• Neoplasm Staging
• Radiation-Sensitizing Agents (therapeutic use)
• Uterine Cervical Neoplasms (drug therapy, pathology)