Polyhematoporphyrin-mediated photodynamic therapy and decortication in palliation of malignant pleural mesothelioma: a clinical pilot study.

The aim of this study was to evaluate the additional effect of intraoperative photodynamic therapy (PDT) under hyperbaric oxygenation (HBO) when compared with decortication alone. From 1/1993 to 8/2002, palliation with decortication was done in 25 patients suffering from advanced malignant pleural mesothelioma. Fourteen patients received additional intraoperative PDT under HBO. The surgery and PDT/HBO was done 48 h after photosensitization with a polyhematoporphyrin, 2 mg/kg/BW using a diode laser delivering red light at 630 nm through a microlens. The light dose was calculated for 300 J with a distance of 1 cm from the tumor surface. At 6-month follow up local tumor control and survival showed a significant difference in both groups. Although the study only includes a small number of patients not allowing definite conclusions, it indicates that the additional PDT/HBO represents a safe and technically feasible approach in the palliative setting of advanced malignant mesothelioma of the pleura.