Shahid Ali Siddiqui1, Shaista Siddiqui2, M A Bilal Hussain1, Shakir Khan3, Hui Liu4, Kafil Akhtar5, Syed Abrar Hasan6, Ibne Ahmed2, Srivalleesha Mallidi7, Amjad P Khan7, Filip Cuckov8, Colin Hopper9, Stephen Bown9, Jonathan P Celli10, Tayyaba Hasan11. 1. Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiotherapy, Aligarh, India. 2. Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiodiagnosis, Aligarh, India. 3. Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Radiotherapy, Aligarh, India; University of Massachusetts at Boston, Boston, MA, United States; Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States. 4. University of Massachusetts at Boston, Boston, MA, United States. 5. Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Pathology, Aligarh, India. 6. Aligarh Muslim University, Jawaharlal Nehru Medical College, Department of Otorhinolaryngology (E.N.T.), Aligarh, India. 7. Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States. 8. Wentworth Institute of Technology, Boston, Massachusetts, United States. 9. University College London, England. 10. University of Massachusetts at Boston, Boston, MA, United States; Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States. 11. Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States; Division of Health Sciences and Technology, Harvard University and Massachusetts Institute of Technology, Cambridge, MA, USA. Electronic address: thasan@mgh.harvard.edu.
Abstract
BACKGROUND: Morbidity and mortality due to oral cancer in India are exacerbated by a lack of access to effective treatments amongst medically underserved populations. We developed a user-friendly low-cost, portable fibre-coupled LED system for photodynamic therapy (PDT) of early oral lesions, using a smartphone fluorescence imaging device for treatment guidance, and 3D printed fibreoptic attachments for ergonomic intraoral light delivery. METHODS: 30 patients with T1N0M0 buccal mucosal cancer were recruited from the JN Medical College clinics, Aligarh, and rural screening camps. Tumour limits were defined by external ultrasound (US), white light photos and increased tumour fluorescence after oral administration of the photosensitising agent ALA (60 mg/kg, divided doses), monitored by a smartphone fluorescence imaging device. 100 J/cm2 LED light (635 nm peak) was delivered followed by repeat fluorescence to assess photobleaching. US and biopsy were repeated after 7-17 days. This trial is registered with ClinicalTrials.gov, NCT03638622, and the study has been completed. FINDINGS: There were no significant complications or discomfort. No sedation was required. No residual disease was detected in 22 out of 30 patients who completed the study (26 of 34 lesions, 76% complete tumour response, 50 weeks median follow-up) with up to 7.2 mm depth of necrosis. Treatment failures were attributed to large tumour size and/or inadequate light delivery (documented by limited photobleaching). Moderately differentiated lesions were more responsive than well-differentiated cancers. INTERPRETATION: This simple and low-cost adaptation of fluorescenceguided PDT is effective for treatment of early-stage malignant oral lesions and may have implications in global health.
BACKGROUND: Morbidity and mortality due to oral cancer in India are exacerbated by a lack of access to effective treatments amongst medically underserved populations. We developed a user-friendly low-cost, portable fibre-coupled LED system for photodynamic therapy (PDT) of early oral lesions, using a smartphone fluorescence imaging device for treatment guidance, and 3D printed fibreoptic attachments for ergonomic intraoral light delivery. METHODS: 30 patients with T1N0M0 buccal mucosal cancer were recruited from the JN Medical College clinics, Aligarh, and rural screening camps. Tumour limits were defined by external ultrasound (US), white light photos and increased tumour fluorescence after oral administration of the photosensitising agent ALA (60 mg/kg, divided doses), monitored by a smartphone fluorescence imaging device. 100 J/cm2 LED light (635 nm peak) was delivered followed by repeat fluorescence to assess photobleaching. US and biopsy were repeated after 7-17 days. This trial is registered with ClinicalTrials.gov, NCT03638622, and the study has been completed. FINDINGS: There were no significant complications or discomfort. No sedation was required. No residual disease was detected in 22 out of 30 patients who completed the study (26 of 34 lesions, 76% complete tumour response, 50 weeks median follow-up) with up to 7.2 mm depth of necrosis. Treatment failures were attributed to large tumour size and/or inadequate light delivery (documented by limited photobleaching). Moderately differentiated lesions were more responsive than well-differentiated cancers. INTERPRETATION: This simple and low-cost adaptation of fluorescenceguided PDT is effective for treatment of early-stage malignant oral lesions and may have implications in global health.
Authors: Jonathan P Celli; Bryan Q Spring; Imran Rizvi; Conor L Evans; Kimberley S Samkoe; Sarika Verma; Brian W Pogue; Tayyaba Hasan Journal: Chem Rev Date: 2010-05-12 Impact factor: 60.622
Authors: Filippo Marchi; Marta Filauro; Andrea Iandelli; Andrea Luigi Camillo Carobbio; Francesco Mazzola; Gregorio Santori; Giampiero Parrinello; Frank Rikky Mauritz Canevari; Cesare Piazza; Giorgio Peretti Journal: Front Oncol Date: 2020-02-04 Impact factor: 6.244
Authors: Srivalleesha Mallidi; Amjad P Khan; Hui Liu; Liam Daly; Grant Rudd; Paola Leon; Shakir Khan; Bilal M A Hussain; Syed A Hasan; Shahid A Siddique; Kafil Akhtar; Meredith August; Maria Troulis; Filip Cuckov; Jonathan P Celli; Tayyaba Hasan Journal: Sci Rep Date: 2019-11-01 Impact factor: 4.379
Authors: Michał Osuchowski; David Aebisher; Dorota Bartusik-Aebisher; Magdalena Krupka-Olek; Klaudia Dynarowicz; Maria Przygoda; Aleksandra Kawczyk-Krupka Journal: Diagnostics (Basel) Date: 2022-04-28