Presently,
malignant diseases are among first for their death rate, with photodynamic
therapy being among first for its therapeutic efficiency. Today’s photodynamic
therapy makes rapid advances. It consistently tackles the problem of irradiating
an introduced photosensitizer. Photosensitizer irradiation is the major
photodynamic procedure, which can be performed in a number of ways:
- Sunlight exposure,
- Color-filter lamp exposure,
- Light-emitting diode array exposure,
- Nonsemiconductor laser exposure, and
- Semiconductor-based laser exposure.
Let
us consider each of the ways. We shall start by comparing the cost of the
radiating sources, which are typical of Russia. We shall also consider the most
typical case where a photosensitizer absorption wavelength corresponds to 660nm
and where the radiation power per tumor is 3W.
It
is evident that although solar radiation is free, it cannot ensure a requisite
exposure. The solar radiation efficiency is very poor: 98 percent of the
radiation does not cause a requisite photoeffect. As a result, the treatment
will produce an overload on the patient, which might cause burns. It is
therefore clear that expensive optics is needed to provide a power of 3W
per tumor at a wavelength of 660nm. However, this is not the 21st
century’s technology.
Color-filter
lamps, which cost US$ 1,000 to 2,000, are rarely employed in photodynamic
therapy. As far back as 1998, Oleg Ksenofontovich Skobelkin showed that such
lamps were not effective. The point is that extremely sophisticated optics is
needed to ensure a requisite power and spectrum (the spectrum width should not
be more than ±10nm).
Furthermore, devices based on color-filter lamps show poor efficiency. They also
require water cooling, which makes the entire system inconvenient for the
physician. In this case, the physician needs to position the lamp and then to
adjust the patient’s location such that the radiation would be incident on the
tumor. This therapeutic procedure relies on the use of expensive special-purpose
beds or armchairs.
Today’s
photodynamic therapy employs devices based on light-emitting diodes. Such
devices cost around US$ 5,000. We do not apply them for a few reasons:
1.
The devices produce an extremely low power density. They are virtually
unable to generate a radiation power of 3W per tumor. Furthermore, they
are almost unable to create a power density more than 300mW/cm2.
2.
The devices employ large numbers of light-emitting diodes, which is
associated with a poor efficiency of light-emitting diodes. They have plenty of
soldered contacts, which makes the devices very unreliable.
3.
The devices cannot be positioned in a thermostat. As a result, the
light-emitting diodes function at room temperature, which can show considerable
variations.
4.
Light-emitting diodes emit wide-spectrum radiation. So, the therapeutic
efficiency of light-emitting diodes is much poorer than that of lasers. In order
that light-emitting diodes and lasers would produce the same therapeutic effect,
devices based on light-emitting diodes should generate a much higher power (as
compared to those based on lasers). This leads to two side effects during
photodynamic therapy: first, the patient’s body is heated and, second, the
patient receives a useless extra light dose.
5.
None of optical systems can make the light distribution of light-emitting
diodes be as uniform as that of lasers.
6.
As far back as 1998, Oleg Ksenofontovich Skobelkin demonstrated that 90
percent of photodynamic therapy operations could be performed using a hair-like
fiber inserted into a cavity, special attachment, or needle. In other words, all
the devices described will be useless in 90 percent of photodynamic operations.
We do not make use of nonsemiconductor lasers in
photodynamic therapy either. The reasons are as follows:
1.
The cost of nonsemiconductor lasers is much higher than that of the
semiconductor ones. In our case, their cost ranges from US$ 30,000 to 200,000.
2.
As described above, there is no sense in using lasers without
light-guiding fibers. Nonsemiconductor lasers are attributed to nonportable
devices because they have very delicate and sensitive optics. The point is that
the lasing media of semiconductor lasers is about 100mm. As a result, all their radiation can be coupled into a light-guiding
fiber of a diameter of 150mm.
The lasing media of other types of lasers are much larger. So, in order to
couple their radiation into a light-guiding fiber of a diameter of 150mm, one needs to use optical systems, which can be easily deranged during
movements.
3.
An overwhelming majority of nonsemiconductor lasers shows a poorer
reliability as compared to semiconductor lasers. Note, the reliability of
semiconductor lasers is rapidly growing.
4.
Currently, industrial semiconductor lasers reveal the highest efficiency
among optical sources. Moreover, the effort of many scientists headed by Nobel
Prize Winner Zhores Ivanovich Alferov allows the efficiency to tend to its
theoretical limit of 100percent.
5.
Semiconductor lasers alone can operate at any wavelength of
photosensitizer sensitivity.
It can thus be concluded that semiconductor lasers
are the most effective radiating sources for photodynamic therapy. This type of
lasers is currently defying competition with other radiating sources (which can
be also used in photodynamic therapy).