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

https://doi.org/10.21294/1814-4861-2025-24-1-174-188

Abstract

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.

About the Authors

S. S. Sklyar
Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Sofia S. Sklyar - MD, PhD, Senior Researcher, Neurooncology Research Laboratory, Neurosurgeon, Oncologist, Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia.

12, Mayakovskogo St., Saint Petersburg, 191014

Researcher ID (WOS) AIF-1772-2022



D. A. Sitovskaya
Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Darya A. Sitovskaya - MD, Pathologist, Researcher, Nervous System Pathomorphology Research Laboratory, Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia.

12, Mayakovskogo St., Saint Petersburg, 191014

Researcher ID (WOS) V-7015-2017



A. Y. Ulitin
Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia; Institute of Medical Education, National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia; North-Western State Medical University named after I.I. Mechnikov of the Ministry of Health of Russia
Russian Federation

Aleksey Y. Ulitin - MD, DSc, Professor, Chief Neurosurgeon of the Saint Petersburg Health Committee, Head of the Department, Institute of Medical Education, National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia; Head of Neurosurgical Department No. 4, Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia; Professor, Department of Neurosurgery, North-Western State Medical University named after I.I. Mechnikov of the Ministry of Health of Russia.

12, Mayakovskogo St., Saint Petersburg, 191014; 21, Kolomyazhsky Ave., Saint Petersburg, 197341; 41, Kirochnaya St., Saint Petersburg, 191015



K. I. Sebelev
Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Konstantin I. Sebelev - MD, DSc, Professor, Leading Researcher, Research Laboratory of Pathomorphology of the Nervous System, Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia.

12, Mayakovskogo St., Saint Petersburg, 191014



E. V. Andreev
Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Evgeny V. Andreev - MD, Radiologist, Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia; Radiologist, City Clinical Oncology Dispensary.

12, Mayakovskogo St., Saint Petersburg, 191014



A. S. Nechaeva
Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Anastasia S. Nechaeva - MD, Neurosurgeon, Junior Researcher, Neurooncology Research Laboratory, Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia; Junior Researcher, Translational Oncology Research Institute, Personalized Oncology Research Center.

12, Mayakovskogo St., Saint Petersburg, 191014



E. Y. Zorina
National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Ekaterina Y. Zorina - MD, PhD, Oncologist, National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia.

2, Akkuratova St., Saint Petersburg, 197341

Researcher ID (WOS) KRQ-9232-2024



A. M. Konova
National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Alexandra M. Konova - MD, Oncologist, National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia.

2, Akkuratova St., Saint Petersburg, 197341

Researcher ID (WOS) KRQ-9240-2024



A. K. Baknina
Institute of Medical Education, National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Alisa K. Baknina - Resident, Institute of Medical Education, National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia.

21, Kolomyazhsky Ave., Saint Petersburg, 197341



M. V. Dikonenko
Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia; Institute of Medical Education, National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Mikhail V. Dikonenko - Junior Researcher of the Stereotactic and Functional Neurosurgery Group, Neurooncology Research Laboratory, Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia; Neurosurgeon, postgraduate student, Neurosurgery Department, Institute of Medical Education, National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia.

12, Mayakovskogo St., Saint Petersburg, 191014; 21, Kolomyazhsky Ave., Saint Petersburg, 197341



K. K. Kukanov
Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Konstantin K. Kukanov - MD, PhD, Neurosurgeon, Senior Researcher, Research Laboratory of Neurooncology, Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia.

12, Mayakovskogo St., Saint Petersburg, 191014



A. E. Vershinin
Institute of Medical Education, National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Aleksandr E. Vershinin - MD, Neurosurgeon, postgraduate student, Department of Neurosurgery, Institute of Medical Education, National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia.

21, Kolomyazhsky Ave., Saint Petersburg, 197341



V. E. Olyushin
Russian Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia
Russian Federation

Viktor E. Olyushin - MD, DSc, Professor, Neurosurgeon, Honored Doctor of the Russian Federation, Chief Researcher, Research Laboratory of Neurooncology, Russian Neurosurgical Institute named after ProfessorA.L. Polenov – a branch of National Medical Research Center named after V.A. Almazov of the Ministry of Health of Russia.

12, Mayakovskogo St., Saint Petersburg, 191014



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Review

For citations:


Sklyar S.S., Sitovskaya D.A., Ulitin A.Y., Sebelev K.I., Andreev E.V., Nechaeva A.S., Zorina E.Y., Konova A.M., Baknina A.K., Dikonenko M.V., Kukanov K.K., Vershinin A.E., Olyushin V.E. A clinical case of successful treatment of the patient with brain metastases using photodynamic therapy and fluorescence diagnostics. Siberian journal of oncology. 2025;24(1):174-188. (In Russ.) https://doi.org/10.21294/1814-4861-2025-24-1-174-188

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ISSN 1814-4861 (Print)
ISSN 2312-3168 (Online)