Therapeutic strategy for peritoneal dissemination of ovarian cancer using dynamic phototherapy and clofibric acid

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This study aimed to investigate the reason why intracellular amount of protoporphyrin IX (PpIX) varies in ovarian cancer cells and the effect of Photodynamic therapy (PDT) on peritoneal carcinomatosa. 1) The amount of PpIX (microg/dl) was 67.7 in DISS cells and 22.4 in MCAS cells. 2) Expression of delta-ALA synthetic enzyme, heme oxygenase and biliverdin reductase B in MCAS increased more then 3 times compared with those in DISS. 3) The rats treated with a methyl ester of 5-aminolevulinic acid (Methyl-ALA)-PDT was significantly longer in survival than those of the control and debulking surgery (DS)-Methyl-ALA-PDT significantly prolonged survival compared with DS alone. These results suggest that PpIX is not accumulated in cells in which heme synthesis and resolution is active and that Methyl-ALA-PDT is promising in ovarian cancer treatment. The amount of PpIX in cells is important in PDT treatment.