Photodynamic therapy of non-melanoma skin cancers - development of a comprehensive image-guided planning system for personalized treatment

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In Radiotherapy, dosimetry and treatment planning are highly advanced for ionizing radiation.Radiation dose is accurately defined and the relationship between it andclinical response is well understood. For photodynamic therapy (PDT), the definition of PDTdose is unclear and how it correlates with clinical response has yet to be precisely defined.Present-day clinical protocols for PDT of non-melenoma skin cancer (NMSC) are relativelystraight-forward: a photosensitizer is administered, a period of time elapses before shininglight and then light with a specific fluence rate illuminates the patient. The same protocol isapplied to an entire patient population and as a result, PDT of NMSC is conducted withoutdetailed customized planning that takes into account patient to patient variability as practicedin radiotherapy. Our research goal is to work on in vivo measurement of optical properties andfunctional parameters such as oxygen levels together with measuring the temporal andspatial photosensitizer concentration uptake. With these quantitative metrics, the hope is thatwe will be able to model and predict the response of individual patients to PDT.. Betterdosimetry will advance the development and utilization of PDT similar to radiation therapywhere the field is very quantitative and evidence-based. Ultimately patient-specific planning ofPDT treatment will increase NMSC clinical outcomes.