Daily Archives: July 12, 2018

Sequential Follow Up In Treating Recurrent Nasopharyngeal Carcinoma With Photodynamic Therapy

OBJECTIVES

o Nasopharyngeal carcinoma (NPC) is endemic in certain parts of Asia, such as Southern China, but occurs sporadically in the Western world

o At Dr. Cipto Mangunkusumo Hospital, Jakarta, there are 90-120 new cases each year

o NPC is sensitive to both radiotherapy and chemotherapy (the first line treatment for NPC is irradiation)

o Several therapeutic modalities have been used in recurrent NPC including external irradiation, brachytherapy, chemotherapy, neck dissection, and combinations of those treatment. Serious side effects are seen following re-irradiation

METHODS

o Foscan (mTHPC, meta-tetrahydroxyphenilchlorin, temorphfin) is a second-generation photosensitizer which is activated by red light (652nm).

o It is a purified synthetic compound with a photophysical efficiency that allows short treatment times (typically 100 to 300 seconds), using small drug dosages

o The period of skin photosensitivity is approximately 2 weeks following injection of Foscan

BACKGROUND

o Photodynamic therapy is a therapeutical concept based on the ability of a number of photo-sensitizers to concentrate in tumor's tissue

o Light of a specific wave length illuminating the sensitized cells can then be used to cause selective necrosis of the tumor

o The tumor is readable by fiberoptic delivery of light energy that facilitating selective tumor destruction while sparing surrounding tissue

o Squamous cell carcinomas of the head and neck have been shown to respond favorably to PDT

o An induced period of generalized photosensitivity remains a side effect of Photodynamic therapy

CASE REPORT

o We reported a 59-year-old man with recurrent stage II NPC post-external radiation 50 Gy locoregional, 2 Gy / day, 5 day / week, with booster 20 Gy into tumor bed seven months earlier

o Foscan was injected with dosage 0.1 mg / kgBW, 48 hours before illumination with PDT

CONCLUSION

o Photodynamic therapy could be an effective local treatment modality for recurrent or persistent nasopharyngeal carcinoma

o PDT treatment of recurrent / persistent NPC has become feasible using a novel nasopharyngeal applicator

o Sequential follow up is necessary and useful for the patient to proof mucosal changes after illumination of photodynamic therapy

* Poster, presented at:

The 16th World Congress of the International Society for Laser Surgery and Medicine

The 1st Congress of the World Federation of Societies for Laser Medicine and Surgery

The 16th Congress of International YAG Laser Society

The 26th Annual Meeting of Japan Society for Laser Surgery and Medicine

Tokyo, Japan, September 7-10, 2005 …

Cataract – Ayurvedic Herbal Treatment

A cataract is a change in the clarity of the natural lens inside the eye that gradually degrades visual quality. The lens plays a crucial role in focusing unimpeded light on the retina at the back of the eye. A significant cataract formation blocks and distorts light passing through the lens, causing visual symptoms and complaints. Cataract development is usually an age-related process because of protein loss in the lens. Other causes of cataract include eye surgery, eye inflammation, congenital cataract, exposure to excessive ultraviolet light, diabetes, smoking, and the use of certain medications like steroids, statins and phenothiazines. Blurred vision, difficulty with glare, increased near-sightedness, and occasionally double vision are some of the symptoms of cataract.

The conventional treatment for cataract is surgical removal along with implantation of an artificial lens. Once a cataract has formed, there is as yet no scientifically proved medication which can clear the cataract and avoid surgery. However, there are a number of Ayurvedic medicines which can be taken in an early age to prevent or delay future cataract formation. Such medicines can be divided into two categories: medicines which act locally on the eyes and medicines which have a general anti-aging effect on the whole body.

Triphala (Three fruits) is a combination which has been recommended for the eyes in the ancient Ayurvedic texts. Triphala consists of Amalaki (Emblica officinalis), Haritaki (Terminalia chebula) and Behada (Terminalia bellerica). Triphala can be used in a decoction form to wash the eyes on a regular basis, and can also be used as eye drops. Triphala-Ghrut is recommended for oral intake on a long term basis to improve the vision in the eyes, cure night blindness and prevent other diseases of the eyes. Medicines like Saptamrut-Loh, which are specially indicated for the eyes, contain Triphala as the main ingredient. In addition, other medicines like Yashtimadhuk (Glycerrhiza glabra), Tulsi (Ocimum sanctum), Shatavari (Asparagus racemosus), Punarnava (Boerhaavia diffusa), Patol (Tricosanthe dioica), Saariva (Hemidesmus indicus), Patha (Cissampelos pareira), Haridra (Curcuma longa) and Daruharidra (Berberis aristata) are also very useful for the eyes. If used on a long term basis, these medicines preserve eye function, prevent degeneration of the lens, prevent or reduce the accumulation of waste products inside the eyes and also prevent abnormal capillary formation in the retina, which can lead to bleeding and premature loss of vision.

The second category of medicines which has a general anti-aging effect on the body is the group of medicines called ‘Rasayanas’. These medicines include Ashwagandha (Withania somnifera), Guduchi (Tinospora cordifolia), Samudrashosh (Argyreia speciosa), Naagbala (Grewia hirsuta), Amalaki, Haritaki, Rasna (Pluchea lanceolata), Aparaajita (Clitoria ternatea), Mandukparni (Centella asiatica), Punarnava, Mudgaparni (Phaseolus trilobus), Mashparni (Teramnus labialis) and Gokshur (Tribulus terrestris). These medicines prevent atherosclerosis and thus ensure a good supply of blood to all the parts of the body. They act directly on each cell of the body and help to maintain an optimum cellular environment. These medicines also act on vital organs like the heart, lungs, kidneys, liver and brain and help …