A clinical case of successful treatment of the patient with brain metastases using photodynamic therapy and fluorescence diagnostics

Background. Cancer incidence is steadily increasing every year, and an estimated 20 % of cancer patients will develop brain metastases. This dictates the need to develop effective treatment modalities. Clinical case description. A 49-year-old female patient was admitted to the Russian Research Neurosurgical Institute with stage IV cT1bN2M1 squamous cell carcinoma of the right lower-lobe bronchus (metastases in the brain) with a local recurrence of metastasis in the right temporal lobe. Removal of the tumor was performed under fluorescent guidance and biospectroscopy using a fiber-optic probe and uno software. Histopathological examination of the biopsy sample and IHC staining confirmed metastastatic squamous cell carcinoma. Photodynamic therapy (PDT) of the bed of the removed tumor was performed using the LFT-02-Biospect laser system (Biospec, Russia) with biospectroscopy. The therapy was completed upon achieving the photobleaching effect and reducing the fluorescence index to values close to normal tissues. The histological examination of the perifocal zone after PDT demonstrated the absence of tumor cells and the presence of pronounced lymphocyte infiltration, which may indicate activation of the immune system. evaluation of the perifocal zone after PDT by means of histological examination demonstrated the absence of tumor cells and the presence of pronounced lymphocyte infiltration, which may indirectly indicate activation of the local immune response. The patient was subsequently observed by an oncologist at her place of residence with follow-up examinations. Antitumor therapy was not prescribed. Conclusion. In this case, no disease recurrence during a follow-up of 11 months, as well as persistent stabilization of the primary tumor with regression of extracranial foci for 6 months was observed. PDT, a treatment method that selectively and locally destroys tumor cells, appears to be safe and promising especially for patients with brain metastases.

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