Student working on a research project.

Image-Guided Interstitial Photodynamic Therapy For Locally Advanced Head And Neck Cancer

Presently there is no universally effective treatment for patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) [1, 2]. Image-guided interstitial photodynamic therapy (I-PDT) is considered one of the most promising treatment modalities [3-8].
I-PDT for LA-HNSCC is performed by inserting an array of laser light sources into the tumor, in the form of catheter-embedded fiber optics, powered by an external source. The emitted light propagates through the tissue to trigger a sequence of chemical reactions with an intravenously introduced light-sensitive drug, known as a photosensitizer (PS)[9]. It is the interaction between light and PS that ultimately leads to cell death[9]. The accumulative effect of the light over time controls the rate of cell death, where its quantity is referred to as the light dose [10]. Ideally, a light-source layout would be selected such that the light dosage is maximized within the target region (the tumor) while minimizing the light exposure to the surrounding healthy tissue. I-PDT for LA-HNSCC often involves the application of multiple light sources.
We have recently demonstrated that image-based finite element method (FEM) can be used for pretreatment planning to calculate the optimal placement of light sources within the tumor during I-PDT, in near real-time (Oakley et al. 2015) [11]. However, in treating LA-HNSCC, the remaining challenge is to implement the treatment planning.
The Shafirstein laboratory developed a new modality for image-guided I-PDT. In this project, the senior design students will test this new technique by developing and building phantoms that mimic LA-HNSCC amenable for I-PDT.

References
[1] Zafereo, M.E., et al. The role of salvage surgery in patients with recurrent squamous cell carcinoma of
the oropharynx. Cancer 115, 5723-5733 (2009).
[2] Janot, F., et al. Randomized trial of postoperative reirradiation combined with chemotherapy after
salvage surgery compared with salvage surgery alone in head and neck carcinoma. Journal of clinical
oncology : official journal of the American Society of Clinical Oncology 26, 5518-5523 (2008).
[3] Jager, H.R., Taylor, M.N., Theodossy, T. & Hopper, C. MR imaging-guided interstitial photodynamic
laser therapy for advanced head and neck tumors. AJNR Am J Neuroradiol 26, 1193-1200 (2005).
[4] Jerjes, W., Upile, T., Akram, S. The surgical palliation of advanced head and neck cancer using
photodynamic therapy. Clin Oncol 22, 785-791 (2010).
[5] Jerjes, W., et al. Photodynamic therapy: The minimally invasive surgical intervention for advanced
and/or recurrent tongue base carcinoma. Lasers Surg Med 43, 283-292 (2011).
[6] Jerjes, W., Upile, T., Alexander, MC., et al. Prospective evaluation of 110 patients following
ultrasound-guided photodynamic therapy for deep seated pathologies. Photodiagnosis Photodyn Ther 8,
297-206 (2011).
[7] Lou, P.J., et al. Interstitial photodynamic therapy as salvage treatment for recurrent head and neck
cancer. Br J Cancer 91, 441-446 (2004).
[8] Karakullukcu, B., van Veen, RL., Aans, JB, et al. MR and CT based treatment planning aof mTHPC
mediated interstitial photodynamic therapy of head and neck cancer: Description of the method. Lasers
Surg Med 45, 517-523 (2013).
[9] Henderson, B.W. & Dougherty, T.J. How does photodynamic therapy work? Photochem Photobiol
55, 145-157 (1992).
[10] Wilson, B.C. & Patterson, M.S. The physics, biophysics and technology of photodynamic therapy.
Phys Med Biol 53, R61-R109 (2008).
[11] Oakley, E., et al. A new finite element approach for near real-time simulation of light propagation in
locally advanced head and neck tumors. Lasers Surg Med 47, 60-67 (2015).

Research Project Information

Student Skill-Set Needed: Undergraduate Senior in the Biomedical Engineering Department
Compensation: Credit for Biomedical Engineering Senior Capstone Design Course
Available: Fall, Spring

Contact

For further information on this opportunity, or to apply, contact:

Faculty Member: Dr. Gal Shafirstein
Title: Select a Title
Affiliation: Roswell Park Cancer Institute
Department: Biomedical Engineering
Email: Gal.Shafirstein@RoswellPark.org