Evaluation of Photodynamic Therapy as Treatment for Spinal Metastases (p. 83-91)
Authors: Margarete K. Akens, Shane Burch and Albert J.M. Yee
Abstract: Spinal metastases occur in 30 % – 70 % of patients with breast cancer. The main symptom in these patients is pain which is caused by destruction of the vertebrae by tumour infiltration and can result in mechanical instability. Treatment options are multi-modal, and include combinations of systemic and local interventions aimed at pain control and improving quality of life. Minimally invasive surgical (MIS) techniques such as vertebroplasty and kyphoplasty are emerging treatment options aimed at relieving pain and improving mechanical stability. These treatments involve the injection of bone cement (polymethylmethacrylate) into the weakened vertebral body, but do not treat the cancer. Therefore, it is thought that local biologic ablation of the vertebral tumour prior to injection of bone cement may be beneficial. One such approach involves photodynamic therapy (PDT), as a non-surgical non-ionizing minimal invasive treatment that could target the inter-vertebral tumour directly. This chapter describes pre-clinical studies evaluating PDT in the treatment of vertebral metastases.