Selective accumulation of a
photosensitizer and the subsequent response in only the light-irradiated target are advantages of photodynamic diagnosis and
therapy. The limited depth of the
therapeutic effect is a positive characteristic when treating surface
malignancies, such as
peritoneal carcinomatosis. For photodynamic diagnosis (PDD), adjunctive use of
aminolevulinic acid-
protoporphyrin IX-guided fluorescence imaging detects
cancer nodules, which would have been missed during assessment using white light visualization only. Furthermore, since few side effects have been reported, this has the potential to become a vital component of diagnostic laparoscopy. A variety of
photosensitizers have been examined for
photodynamic therapy (
PDT), and treatment protocols are heterogeneous in terms of
photosensitizer type and dose,
photosensitizer-light time interval, and light source wavelength, dose, and dose rate. Although several studies have suggested that
PDT has favorable effects in
peritoneal carcinomatosis, clinical trials in more homogenous patient groups are required to identify the true benefits. In addition, major complications, such as bowel perforation and
capillary leak syndrome, need to be reduced. In the long term, PDD and
PDT are likely to be successful therapeutic options for patients with
peritoneal carcinomatosis, with several options to optimize the
photosensitizer and light delivery parameters to improve safety and efficacy.