Photodynamic therapy in gynaecological cancer

Tumour recurrences in the gynaecological field after conventional therapy are a big problem because there is little choice for other therapies without inflicting further damage. Photodynamic therapy (PDT) is indicated because it is selective and without side-effects in flat or small recurrences. We treated 15 patients with vaginal and vault recurrences of cervix carcinoma, adenocarcinoma in the corpus uteri and rectum. The PDT was performed after 24-48 h with Hp, 5 mg/kg body weight, injection, and an argon-dye laser for 13 cases, tungsten and xenon lamps in 2 cases. All patients were previously treated with conventional therapy (i.e. surgery, radiotherapy, chemotherapy). Doses ranged from 60 to 500 J cm^-2. The results were: 8 complete local responses, 6 partial responses, 1 no change. Four patients died because of distant metastases or progression. One partial response was treated with brachytherapy and is now disease free. All the other patients are still living. In all cases we have seen no side-effects from PDT. The patients were sheltered from the sunlight for 20-30 days after therapy.