Abstract
Cholangiocellular cancer (CCC) is an oncological disease of the bile ducts characterized by a high mortality rate. To date, the use of standard methods for the diagnosis and treatment of CCC has not been able to reduce mortality from this disease. This work presents the results of fluorescence diagnostics (FD), which consists in using a modified optical fiber and photodynamic therapy (PDT) using a therapeutic laser instead of a low-intensity laser. This technique was tested on 43 patients in a clinical setting. The results obtained indicate a direct correlation between spectroscopic and video FD methods. Furthermore, a direct correlation was found between the photobleaching of a chlorin e6-based photosensitizer, with the commercial names of Photolon Radachlorin and Photoran and stricture regression. Our findings demonstrate the possibility of using a therapeutic laser with a wavelength of 660 nm for both diagnosis and treatment of bile ducts cancer, which results in a significant reduction of the operation time without decreasing its effectiveness.
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This work was funded by RFBR according to the research project (Nos. 17-00-00162 and 17-00-00159).
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Ethics Approval The trial was conducted in accordance with the Declaration of Helsinki. This study was reviewed and approved by the Integrated Research Ethics Council of First Sechenov State Medical University, Ministry of Health of the Russian Federation (Sechenov University) (approval number 127, 12.09.2018). All registered patients completed an informed consent form.
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Dmitry V. Yakovlev, graduated student of N.I. Pirogov Russian National Research Medical University in Moscow, Russia (2019). Nowadays, Dmitry is a researcher at Laser Biospectroscopy Laboratory of Prokhorov General Physics Institute of Russian Academy of Sciences. He develops new approaches and equipment for diagnosis of cholangiocellular cancer via spectroscopy methods. The investigation will assist to oncologists in tumor margin detection during less invasive operations with complete removal in hepatobiliary area. In addition, Dmitry is a Ph.D. student at Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, where he develops hybrid nanostructures for fluorescence diagnostics and photodynamic therapy using two-photon excitation.
Dina S. Farrakhova proved master’s thesis at Institute of Laser and Plasma Technology at National Research Nuclear University MEPhI (NRNU MEPhI) in Moscow, Russia (2018). The research is in a fluorescence diagnostic and photodynamic therapy for cancer treatment via spectroscopy and video-fluorescence methods. Nowadays, Dina is a junior researcher at Laser Biospectroscopy Laboratory of Prokhorov General Physics Institute of Russian Academy of Sciences. She develops new approaches and equipment for diagnosis of head and neck cancer via spectroscopy methods. The investigation will assist to oncologists in tumor margin detection during less invasive operations with complete removal in head and neck area. In addition, Dina researches distribution of promising photosensitizers on multicellular tumor spheroid models for enhancing of cancer cell destruction during photodynamic therapy.
Artem A. Shiryaev, Ph.D. (2010), surgeon, oncologist, interventional radiologist of Institute of Cluster Oncology named after L.L. Levshin under Sechenov University, Moscow, Russia. He engages in development of methods for laser-fluorescent diagnostics, and photodynamic therapy (PDT) in oncology, methods of intraoperative video-fluorescence diagnostics and PDT. He takes part as Investigator or Principal Investigator in the research projects that are being implemented with financial support from Russian Foundation for Basic Research (RFBR). Artem has presented in various professional conferences and has more than 40 published works including publications in peer-eviewed journals, such as Photodiagnosis and Photodynamic Therapy, Journal of Clinical Medicine,European Journal of Surgical Oncology, Laser Physics, Optical Engineering, and Biomedical Photonics. He is also the author or co-author of more than 2 patents.
Kanamat T. Efendiev received his Master’s degree in 2019 from National Research Nuclear University MEPhI, Russia. His pre-graduate practice and laboratory research took place at Department of Laser Micro-, Nano-, and Biotechnology, Institute of Engineering Physics for Biomedicine. He was engaged in the development of devices and methods for infrared imaging. Now Kanamat is a postgraduate student of National Research Nuclear University MEPhI at department No. 87 “Laser Micro-, Nano- and Biotechnologies”. He is developing methods for fluorescence imaging of highly pigmented tumors.
Maxim V. Loshchenov is a senior scientist at Prokhorov General Physics Institute of Russian Academy of Sciences, associate professor at National Research Nuclear University MEPhI, Russia. He received the degree of “Candidate of Physical and Mathematical Sciences”, equal to the international Ph.D. degree, in 2006 with the topic of Ph.D. Thesis: “Minimally invasive diagnostics of glucose concentration and light distribution in biological tissues”. During 2006–2010, he accomplished two postdoc terms in University of Toronto, Canada. From 2010 till present, he is working as senior researcher in Laser Biospectroscopy Laboratory (Center for Nature Science Investigations, General Physics Institute of the Russian Academy of Sciences, Moscow, Russia) on research and development of new devices and methods, for fluorescent diagnostics of cancer. Novel video-fluorescent computer-assisted systems for diagnostics are in the field of his scientific interests.
Liana M. Amirkhanova studied at Sechenov First Moscow State Medical Univesity, 2012–2018, Specialty “General Medicine”. She graduated from the residency in oncology in 2018–2020. She currently works as an oncologist.
Dmitry O. Kornev graduated from the medical faculty of Ulyanovsk State University, Russia with a degree in Medicine with a higher degree in 2019. He is currently studying in the residency of Sechenov University, Moscow, with a degree in Oncology, and has a degree in General Medicine.
Vladimir V. Levkin, Ph.D. (1986), surgeon, oncologist, professor of Department and Clinic of Faculty Surgery No. 1 named after academician N.N. Burdenko of I.M. Sechenov First Moscow Medical University (Sechenov University), Russia. He engages in development of methods for laser-fluorescent diagnostics, and photodynamic therapy (PDT) in oncology, methods of preoperative and intraoperative spectro-video-fluorescence diagnostics and PDT. His Ph.D. (1995) and doctoral dissertations (2013) were devoted to these research areas, as well as to improve the functional and long-term results of surgical treatment, primarily for stomach cancer. In addition to medical and scientific activities, he is actively engaged in teaching, instilling interest and love for students in scientific work. Vladimir has presented in various professional conferences and has more than 60 published works including publications in peer-reviewed journals, such as Photodiagnosis and Photodynamic Therapy, Journal of Clinical Medicine, Laser Physics, Optical Engineering, and Biomedical Photonics.
Igor V. Reshetov, Full Member RAS, Professor, Doctor of Medical Sciences, Director of Institute of Cluster Oncology named after L.L. Levshin under Sechenov University, Head of Department of Oncology, Radiotherapy and Plastic Surgery, Institute of Clinical Medicine named after N.V. Sklifosovsky under Sechenov University, Head of Department of Oncology with the course on Reconstructive Plastic Surgery at Federal Medical-Biological Agency, Russia. He graduated from the 2-nd Moscow State Medical Institute named after N.N. Pirogov in 1987. He gained a Doctor of Science Degree in Oncology in 1998. He was elected the Full Member of Russian Academy of Sciences in 2016. He is a laureate of a number of Russian and international awards, including two Russian Federation Government Prize in Science and Technology, the award for the best report by the European Society of Surgical Oncology, and the N.N. Blokhin Prize in Oncology by Russian Academy of Medical Sciences. He was awarded by the Gold Medal of the British Invention Show (2013), the Diploma of the Ministry of Health of the Russian Federation, the Medal of Ivan Kalita Order by the Moscow Region Government, the Lapel badge “Excellent Worker of Public Health”, etc.
Victor B. Loschenov is professor and head of laboratory at Prokhorov General Physics Institute of Russian Academy of Sciences, professor at National Research Nuclear University (NRNU) MEPhI, Russia. His research interests are focused on fundamentals and practical applications of photodynamic therapy and fluorescent diagnostics of cancer, medical devices, phototheranostics, different modalities of optical spectroscopy. He received the Ph.D. degree in 1981 from N.S. Kurnakov Institute of General and Inorganic Chemistry, Academy of Sciences of the USSR on specialty “Quantum radio physics”. In 2006, he received the degree of doctor of science in Laser Physics from Prokhorov General Physics Institute of Russian Academy of Sciences with subject: “Methods and apparatus for spectral-fluorescence diagnosis and photodynamic therapy”. Since 2007, he has a title of professor in Laser physics. His professional experience includes the position of head of Laser Biospectroscopy Laboratory at GPI RAS (Moscow, Russia) (from 1989 till present) and professor and head of department in NRNU MEPhI, Russia.
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Yakovlev, D.V., Farrakhova, D.S., Shiryaev, A.A. et al. New approaches to diagnostics and treatment of cholangiocellular cancer based on photonics methods. Front. Optoelectron. 13, 352–359 (2020). https://doi.org/10.1007/s12200-020-1093-0
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DOI: https://doi.org/10.1007/s12200-020-1093-0