Abstract
The dose-response behaviour in total-bladder photodynamic therapy (PDT) is calculated for both the argon-pumped dye laser (630 nm) and the argon laser (488/514.5 nm) wavelengths delivered in two light-delivery methods by using an isotropically emitting fibre placed in the centre of the bladder cavity. Method 1 assumes that the bladder is filled with a perfectly clear medium. In method 2, this is replaced with a perfectly scattering medium. Two assumptions are made: that the bladder is a perfect sphere whose wall thickness is much smaller than its radius, and that there is refractive-index matching between the bladder tissue and the liquid filling the bladder cavity. The optical properties of healthy dog bladder, measured in vitro, are used in the one-parameter diffusion approximation to the radiative transport equation to calculate the distribution of the light fluence rate inside the bladder wall. The integrating-sphere effect of this geometry is explicitly accounted for. Threshold fluences for tumour necrosis are obtained from previous animal experiments. The results confirm that the argon laser provides the method of choice to treat widespread superficial bladder cancer, albeit with a greater risk of damage to the healthy lamina propria. Method 2 predicts better efficiency than method 1, provided that the tumour is superficial. Possible reasons for differences between calculated dose-response curves and clinical results are discussed. The analysis suggests a simple and practical method to assess the clinical dose-response curve from a knowledge of: (a) the local, incident light-dose during (focal) treatment; (b) the resulting depth of PDT-necrosis; and (c) the optical properties of diseased human-bladder tissue.
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Van Gemert, M.J.C., Cheong, WF., Welch, A.J. et al. Light delivery for whole-bladder photodynamic therapy. Laser Med Sci 2, 273–284 (1987). https://doi.org/10.1007/BF02594172
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DOI: https://doi.org/10.1007/BF02594172