US20090216300A1 - Method and apparatus for light-activated drug therapy - Google Patents
Method and apparatus for light-activated drug therapy Download PDFInfo
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- US20090216300A1 US20090216300A1 US12/161,323 US16132307A US2009216300A1 US 20090216300 A1 US20090216300 A1 US 20090216300A1 US 16132307 A US16132307 A US 16132307A US 2009216300 A1 US2009216300 A1 US 2009216300A1
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- drug therapy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0613—Apparatus adapted for a specific treatment
- A61N5/062—Photodynamic therapy, i.e. excitation of an agent
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K41/00—Medicinal preparations obtained by treating materials with wave energy or particle radiation ; Therapies using these preparations
- A61K41/0057—Photodynamic therapy with a photosensitizer, i.e. agent able to produce reactive oxygen species upon exposure to light or radiation, e.g. UV or visible light; photocleavage of nucleic acids with an agent
- A61K41/0071—PDT with porphyrins having exactly 20 ring atoms, i.e. based on the non-expanded tetrapyrrolic ring system, e.g. bacteriochlorin, chlorin-e6, or phthalocyanines
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0601—Apparatus for use inside the body
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- A—HUMAN NECESSITIES
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- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0601—Apparatus for use inside the body
- A61N5/0603—Apparatus for use inside the body for treatment of body cavities
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
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- A61N5/067—Radiation therapy using light using laser light
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00084—Temperature
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00274—Prostate operation, e.g. prostatectomy, turp, bhp treatment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22065—Functions of balloons
- A61B2017/22068—Centering
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00273—Anchoring means for temporary attachment of a device to tissue
- A61B2018/00279—Anchoring means for temporary attachment of a device to tissue deployable
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- A61B2018/00636—Sensing and controlling the application of energy
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- A61B2018/00791—Temperature
- A61B2018/00821—Temperature measured by a thermocouple
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- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
- A61B2018/2255—Optical elements at the distal end of probe tips
- A61B2018/2261—Optical elements at the distal end of probe tips with scattering, diffusion or dispersion of light
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- A61N5/0601—Apparatus for use inside the body
- A61N5/0603—Apparatus for use inside the body for treatment of body cavities
- A61N2005/061—Bladder and/or urethra
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- A61N5/06—Radiation therapy using light
- A61N2005/065—Light sources therefor
- A61N2005/0651—Diodes
- A61N2005/0652—Arrays of diodes
Definitions
- the present invention relates generally to a prostate treatment system for treating prostatic tissue in combination with a photoactive agent, and more specifically a transurethral device in combination with a light-activated drug for use in treating benign prostatic hyperplasia (BPH).
- BPH benign prostatic hyperplasia
- Benign prostatic hyperplasia BPH
- prostate cancer are common conditions in the older male population.
- the enlarged prostate can compress the urethra causing obstruction of the urine pathway, which results in difficulty urinating.
- the enlarged prostate can also cause urethral stones, inflammation, infection and in some instances, kidney failure.
- Major treatment methods for BPH include surgical treatment such as a prostatectomy or transurethral resection of the prostate. These treatments require the patient to be hospitalized, which can be a financial burden to the patient. Additionally, surgical procedures can result in significant side effects such as bleeding, infection, residual urethral obstruction or stricture, retrograde ejaculation, and/or incontinence or impotence. Patients who are too old or who have weak cardiovascular functions are not good candidates for receiving these treatment methods.
- Photodynamic treatment (PDT) methods are new methods for treating cancers.
- light-activated drug therapy also known as PDT
- light of a specific wavelength or waveband is directed toward a target cell or cells that have been rendered photosensitive through the administration of a photoreactive, photoinitiating, or photosensitizing agent.
- the drug is commonly administered to the patient via intravenous injection, oral administration, or by local delivery to the treatment site.
- a light source emitting certain wavelength or waveband can be used to irradiate the cancerous tumor or the enlarged tissue by activating the photosensitizer to produce a strong oxidizing agent that can kill the cancerous tumor or enlarged tissues.
- the light-activated drug therapy is minimally invasive, less costly, and has a lower risk of complications.
- One type of light delivery system used for light-activated drug therapy comprises the delivery of light from a light source, such as a laser, to the targeted cells using an optical fiber delivery system with special light-diffusing tips on the fibers.
- This type of light delivery system may further include optical fiber cylindrical diffusers, spherical diffusers, micro-lensing systems, an over-the-wire cylindrical diffusing multi-optical fiber catheter, and a light-diffusing optical fiber guide wire.
- This light delivery system generally employs a remotely located high-powered laser, or solid-state laser diode array, coupled to optical fibers for delivery of the light to the targeted cells.
- the light source for the light delivery system used for light-activated drug therapy may also be light emitting diodes (LEDs) or solid-state laser diodes (LDs). LEDs or LDs may be arrayed in an elongated device to form a “light bar” for the light delivery system.
- the LEDs or LDs may be either wire bonded or electrically coupled utilizing a “flip chip” technique that is used in arranging other types of semiconductor chips on a conductive substrate.
- Various arrangements and configurations of LEDs or LDs are described in U.S. Pat. Nos. 5,445,608; 6,958,498; 6,784,460; and 6,445,011, which are incorporated herein by reference.
- the largest diameter of the light bar is defined by human anatomy and the smallest diameter is defined by the size of the light emitters that emit light of a desired wavelength or waveband at a sufficient energy level, and the fragility of the bar as its thickness is reduced, which increases the risk of breaking in the patient.
- a transurethral treatment device can include an elongated support member configured to pass through the urethra, a light delivery device, and a positioning element carried by the support member.
- the support member can be a catheter having at least one lumen, or in other embodiments the support member can be a generally closed body without a lumen.
- the light delivery device can have a light generator along the support member and a light emitting region configured to be positioned within the urethra at least proximate to a treatment site.
- the light generator is configured to generate light at a preselected wavelength or waveband in the range of an activation waveband of a photoactive composition.
- the positioning element is configured to locate the light emitting region within the urethra at least proximate to the treatment site.
- the positioning element for example, can be a balloon or indicators on the support member.
- a transurethral treatment device comprises a light delivery device positionable within or along an elongated support member for treatment of benign prostatic hyperplasia (BPH).
- the light delivery system may include light emitting diodes (LEDs), laser diodes (LDs), or may include a diffusion quartz fiber tip connected to an internal source of light energy.
- the treatment device may further include a temperature monitoring system for monitoring the temperature at the treatment site and a urine drainage system.
- the treatment device has a light delivery device positioned within a catheter-like device, such as a Foley catheter or a conventional balloon catheter.
- a light bar sized to fit into a standard or custom optically clear Foley catheter, is inserted into the catheter which has been placed via the urethra at the prostate.
- the device can be used in a sterile Foley catheter or can be delivered in a sterile pack kit prepackaged with the catheter and/or an appropriate photoactive agent dose so that it is convenient for prostatic procedures, and thus facilitates treatment in a non-surgical environment leading to potential reduction in costs and medical complications.
- the transurethral treatment device can have an outer diameter of about 0.8 mm to about 10 mm (e.g., 2.5 mm).
- the light source may have a cross-sectional dimension of about 0.5 mm to about 1.5 mm, but in other embodiments it can be larger.
- the size of an LED for example, can be approximately 0.25 mm to 1 mm.
- the transurethral treatment device, light source and LEDs can have other cross-sectional dimensions.
- the light bar may further include an encapsulant made from a flexible polymeric material with an appropriate refractive index to ensure efficient light coupling into the body.
- the encapsulant can also be made from opaque or reflective material to direct the light to the targeted tissues and to protect other tissues.
- non-LED light sources such as laser diodes (LDs) can be used. Generated light can be transmitted to the treatment site via optical fibers.
- the light delivery system may further include a diffusion quartz fiber tip connected to a source of light.
- the light emitting region of the treatment device is fixed in place in the elongated support member.
- the light emitting region of the light delivery device is movable within or along the elongated support member. For example, at the end of the treatment the light delivery device may be removed and the elongated support member left in place to act as a urine drain.
- the treatment device may further include printed markings or indicia on the catheter to aid in placement of the light bar within the catheter.
- the catheter has a selective coating to control where light transmits to the prostatic tissue thus directing the light activate drug therapy and reducing the potential to treat adjacent tissue.
- a Y-connection with a leakage control valve is included to allow the light delivery device to be inserted into the elongated support member through a separate lumen from a urine collection lumen.
- the elongated support member may include one or more lumens as needed to provide light transmission source manipulation and placement.
- the elongated support member may include a balloon to further aid in positioning the light delivery device proximate to the prostate using non-incision type methods.
- the catheter may include a retractable fixation device such as balloon, umbrella, tines, disk or other means for fixation and placement within the bladder.
- the elongated support member and light bar may include echogenic material to reflect high-frequency sound waves and thus be imageable by ultrasound techniques. Echogenic material will aid in proper placement of the elongated support member and the light bar in operation.
- the light delivery system also includes temperature sensors which are electrically connected to temperature monitors for monitoring temperature at the treatment site.
- the treatment device may be used to treat prostate cancer, prostatits, cystitis, bladder cancer, hypertrophic trigone, and hypertrophic urethral sphincter.
- the present invention utilizes light-activated drug therapy to minimally-invasively treat BPH or prostate cancer via the urethra. As a result, patients with BPH or prostate cancer can be treated using the present invention without being admitted to a hospital, undergo general anesthesia and blood transfusion, and thus have lower risk of complications.
- a photosensitizer is administered intravenously before activating the light delivery device.
- the light activates the photosensitizer to promote cell death in the prostatic tissue.
- the device provides a minimally invasive transurethral method for treating BPH, prostate cancer or other prostatic conditions. This type of light-activated drug therapy would treat prostatic tissue, for example, by causing cell death in the prostatic tissue. Such cell death and the absorption of the tissue by the patient's body would create an opening for urine to flow from the bladder out the urethra.
- the invention also provides methods of administering light-activated drug therapy to treat targeted tissue of a human or non-human patient.
- the method includes identifying a location of tissue to be treated in the prostate; inserting an elongated support member into the urethral tract to position a light emitting region at least proximate to the location of the targeted tissue; and administering an effective dose of a photoactive composition to the targeted tissue.
- the method may include confirming placement of the light source prior to treatment.
- the method further includes treating the targeted tissue with light-activated drug therapy for a predetermined period of treatment.
- the light-activated drug is mono-L-aspartyl chlorine e 6 , also referred to herein as Talaporfin Sodium.
- This compound's absorption spectrum has several absorption bands: 400-420 nm (e.g., peak of about 411 nm), 500-520 nm (e.g., peak of about 507 nm), and 655-670 nm (e.g., peak of about 664 nm).
- the drug could be excited at any of these bands.
- Alternative light-activated drugs of suitable excitation wavelengths may also be used as is known in the art.
- FIG. 1 is an elevational side view of a prostate treatment system having a transurethral treatment device according to one embodiment of the invention.
- FIG. 2 is a cross-sectional view taken along line 2 - 2 of FIG. 1 illustrating one embodiment of lumens in the transurethral treatment device.
- FIG. 3 is side view of a transurethral treatment device positioned in the urethra tract of a patient according to an embodiment of the invention.
- FIG. 4 is a cross-sectional view of a transurethral treatment device in accordance with another embodiment of the invention.
- FIG. 5 is a cross-sectional view of a transurethral treatment device in accordance with yet another embodiment of the invention.
- FIG. 6 is a cross-sectional view of a transurethral treatment device in accordance with still another embodiment of the invention.
- FIG. 7 is a cross-sectional view of a transurethral treatment device in accordance with another embodiment of the invention.
- a prostate treatment system can include a transurethral treatment device having a light delivery device positioned within or along an elongated support member for treatment of benign prostate hyperplasia (BPH) and other prostate conditions.
- the treatment device includes a light delivery device disposed on the surface of the elongated support member, or in other embodiments, the light delivery device is within a lumen of the elongated support member.
- the light generator can be optically connected to a light emitting region via optical fibers or light guides. Alternatively, the light generator and the light emitting region may be positioned together at the distal end of the elongated member at least proximate to a treatment site.
- the light generator may include a laser, an LED, a thin plastic sheet material which produces light at a selected wavelength or waveband, or other suitable light sources that can be transmitted to or placed at the treatment site.
- the transurethral treatment device also includes temperature sensors which are electrically connected to temperature monitors.
- FIG. 1 illustrates a prostate treatment system 20 including a power supply 1 and a transurethral treatment device 21 having an elongated support member 2 and a light delivery device 6 positioned along or within the support member 2 .
- the transurethral treatment device 20 may further includes a balloon 3 or other type of positioning element carried by the elongated support member 2 .
- the support member 2 can be a catheter having a lumen 4 , or the support member 2 can be a closed body without a lumen.
- the support member 2 has a total length of 400 to 450 mm and has an outer diameter of 3.327 mm, and the balloon 3 at the distal end of the support member 2 has a volume of 10 to 30 ml and is used to position and fix the light delivery device 6 proximate to the treatment site such as the prostate.
- the light delivery device 6 can have a light generator 6 a and a light emitting region 6 b .
- the light generator 6 a and the light emitting region 6 b are at approximately the same location of the elongated member, but in other embodiments shown below, the light generator 6 a may not be coincident with the light emitting region 6 b .
- the light generator 6 a may be located towards the proximal end of the support member 2 .
- the support member 2 is a catheter with a lumen 4
- the light delivery device 6 can move within the lumen to be positioned relative to the treatment site.
- the light delivery device 6 can be disposed on the surface of the catheter 2 below the balloon 3 or other type of positioning element.
- the power for the light generator can be transmitted to the light delivery device 6 via a lead wire 7 coupled to the power source 1 .
- light could be emitted by a light emitting diode (LED), a laser diode, light-emitting polymer, or a quartz fiber tip optically coupled to another internal source of light energy.
- the support member 2 can include a plurality of lumens therein.
- the balloon 3 is connected to a fluid inlet 5 via lumen 4 .
- Gas or liquid can be pumped into inlet 5 and through lumen 4 to inflate balloon 3 .
- the transurethral treatment device 21 can optionally have a urine aperture 11 positioned at the distal end of the support member 2 that is connected to a urine collection bag 13 via a urine lumen 12 .
- the urine aperture 11 can be used to collect the patient's urine during treatment.
- the transurethral treatment device 21 can also optionally include a temperature measuring system having at least one of a temperature sensor 8 and a temperature monitor 10 .
- the temperature sensor 8 can be a thermocouple or other sensor as is known in the art.
- the temperature sensor 8 is disposed on or thermally coupled to a surface of the support member 2 and is electrically connected to the temperature monitor 10 via wires 9 disposed within the support member 2 .
- the temperature sensor 8 measures a temperature at the treatment site, for example, proximate to the prostate during treatment.
- a control loop (not shown) may further be connected to the temperature monitor 10 to automatically shut the treatment device off in the event that the temperature at the treatment site exceeds a predetermined value.
- the temperature monitor 10 may further include a warning device (not shown), such as a visual indicator or audible indicator, to provide an operator with a warning that a predetermined temperature has been reached or is being exceeded during treatment.
- the treatment device is positioned transurethrally to allow access to the prostate, followed by administration of a photoactive drug, by injection, intravenously, or orally.
- the transurethral treatment device 21 and more specifically a portion of the support member 2 , can be directed into the urethra under topical anesthesia.
- 4 to 10 ml of saline or air can be pumped into the balloon 3 via the air pumping channel 4 to inflate the balloon 3 .
- the support member 2 can be pulled slightly proximally such that the balloon 3 can be fixed at the inner opening of the urethra.
- the light delivery device 6 can be positioned at least proximate to or within the prostate.
- the photoactive drug can then be administered to the patient, and the light generator 6 b can be activated.
- the support member 2 has a proximal portion and a distal portion relative to a power controller.
- the distal portion of support member 2 includes the light delivery device 6 .
- the light delivery device comprises a plurality of LEDs in electrical communication with the power supply via lead wires 7 as shown in FIG. 1 .
- the lead wires may be selected from any suitable conductor that can be accommodated within the dimensions of the support member, for example: a bus bar that electronically couples the LEDs to the controller; flexible wires; a conductive film or ink applied to a substrate, and the like.
- the light delivery device may include Bragg reflectors to better control the wavelength of the light that is to be transmitted to the target cells.
- a power controller 1 may be programmed to activate and deactivate LEDs of a light delivery device in a pulsed sequence or a continuous sequence.
- the LEDs may form two halves of the light array that may be turned on and off independently from each other.
- the system may be programmed to selectively activate and deactivate (e.g., address) different selected individual or groups of LEDs along the length of the bar.
- a treatment protocol for example causing the LEDs to be lit in a certain sequence or at a particular power level for a selected period of time, may be programmed into the controller. Therefore, by selectively timing the pulses and/or location of the light, the system delivers light in accordance with a selected program.
- LEDs can be powered by DC continuously.
- Examples of addressable light transmission arrays are disclosed in U.S. Pat. No. 6,096,066, herein incorporated in its entirety by reference.
- Exemplary light transmission arrays which include shielding or distal protection are disclosed in U.S. patent application Ser. Nos. 10/799,357 and 10/888,572, herein incorporated in their entirety by reference.
- the efficacy of the light-activated drug therapy is improved, given that the treated tissue is allowed to reoxygenate during the cycles when the light is off.
- tissue oxygenation during therapy is improved by using a lower frequency.
- the operational frequency is 50 Hz-5 kHz, and in one embodiment, is 50-70 Hz.
- the treatment device may further include a temperature monitoring system for monitoring the temperature at the treatment site.
- the support member 2 is a Foley catheter and the light delivery device 6 is disposed in the Foley catheter.
- the treatment device has a light delivery device disposed in a conventional balloon catheter.
- Foley catheters are available in several sub-types, for example, a Coude catheter has a 45° bend at the tip to allow easier passage through an enlarged prostate.
- Council tip catheters have a small hole at the tip which allows them to be passed over a wire.
- Three-way catheters are used primarily after bladder, prostate cancer or prostate surgery to allow an irrigant to pass to the tip of the catheter through a small separate channel into the bladder. This serves to wash away blood and small clots through the primary arm that drains into a collection device.
- FIG. 4 is a cross-sectional view of still another embodiment of a transurethral treatment device 21 .
- the light delivery device includes a light generator 6 a along the support member 2 at a location that is either within or external (shown) to the patient.
- the light delivery device can further include a light emitting region 6 b positioned at least proximate to the treatment site and a light transmitting region 6 c (e.g., fiber optic) between the light generator 6 a and the light emitting region 6 b .
- the support member 2 can be a catheter through which the light delivery device 6 can be moved for positioning, or the support member can be a closed body to which the light delivery device 6 is attached (e.g., fixed at a set position).
- FIGS. 5-7 are cross-sectional views showing additional embodiments of portions of transurethral treatment devices.
- FIG. 5 more specifically, shows a device having a closed body support member 2 and a light delivery device fixed to the support member 2 .
- the light delivery device has a light generator 6 a , a light emitting region spaced apart from the light generator 6 a distally along the support member 2 , and a light transmitting region 6 c between the light generator 6 a and the light emitting region 6 b .
- the light transmitting region 6 c conducts light from the light generator 6 a to the light emitting region 6 b .
- FIG. 5 shows a device having a closed body support member 2 and a light delivery device fixed to the support member 2 .
- the light delivery device has a light generator 6 a , a light emitting region spaced apart from the light generator 6 a distally along the support member 2 , and a light transmitting region 6 c between the light generator 6 a and the light emit
- FIG. 6 illustrates a device having a solid or otherwise lumen-less support member 2 and a light delivery device 6 with a light generator 6 a and a light emitting region 6 b at the same location longitudinally along the support member 2 .
- the light generator is within the support member 2 .
- FIG. 7 shows still another embodiment in which the light delivery device is on a surface of the support member. More specifically, the light delivery device 6 has the light generator 6 a and the light emitting region 6 b disposed on an external surface of the support member.
- a light delivery system that is sized to fit into a standard or custom optically clear Foley catheter is inserted into that catheter which has been placed via the urethra at the prostate.
- the light delivery device can be used with a sterile Foley catheter or can be delivered in a sterile pack kit prepackaged with the catheter and/or an appropriate photoactive agent dose so that it is convenient for prostatic procedures.
- the light bar or light array may include a plurality of LEDs contained in a catheter assembly or otherwise attached to a closed elongated support member.
- the support member 2 may have an outer diameter of about 0.8 to about 10 mm.
- Example of LED arrays are disclosed in U.S. application Ser. No. 11/416,783 entitled “Light Transmission system for Photo-reactive Therapy,” and U.S. application Ser. No. 11/323,319 entitled “Medical Apparatus Employing Flexible Light Structures and Methods for Manufacturing Same,” herein incorporated in their entirety by reference.
- Additional embodiments have a power controller drive circuit capable of producing constant current D.C., A.C., square wave and pulsed wave drive signals. This is accomplished by combining a constant source with a programmable current steering network allowing the controller to selectively change the drive wave form. For example, the steering network may be modulated to achieve the various functions described above, for example, producing the desired impedance to fully discharge the battery.
- use of an A.C. drive allows for a two-wire connection to the LEDs, thereby reducing the cross-sectional diameter of the catheter, while still permitting use of two back-to-back emission sources, that when combined, produce a cylindrical light source emission pattern.
- the transurethral treatment device 21 can comprise a unitary, single use disposable system for light-activated drug therapy. It should be noted that in certain embodiments the catheter is fused to the power controller to form an integrated single unit. Any attempt to disconnect the support member in this embodiment results in damage to either the catheter, or module, or both.
- the prostate treatment system can be used in connection with any light-activated drug of which there are many known in the art and some of which are listed in U.S. Pat. No. 7,015,240 which is fully incorporated by reference with regard to disclosed photoactive compositions.
- the light-activated drug is Talaporfin Sodium.
- Talaporfin Sodium is a chemically synthesized photosensitizer, having an absorption spectrum that exhibits a maximum peak at 664 nm.
- the Talaporfin Sodium is presented as a lyophilized powder for reconstitution. One hundred milligrams of Talaporfin Sodium is reconstituted with 4 milliliters of 0.9% isotonic sterile sodium chloride solution, to give a solution at a concentration of 25 mg/ml.
- the drug must be activated with light, and light energy is measured here in Joules (J) per centimeter of length of the light transmitting array. Likewise the fluence of light is measured in milli-watts (mW) per centimeter of length of the light emitting array.
- J Joules
- mW milli-watts
- the fluence may be delivered for only a fraction of the treatment time, because the light array may be pulsed, for example in a frequency such as 60 kHz, or may be controlled by a timing pattern.
- a timing pattern is that the array is at full fluence for 20 seconds, then off for 10 seconds in a repetitive cycle.
- the control module may further be programmable in embodiments for such fractionated light delivery.
- light energy in the range from about 50 to about 1000 J/cm of light array fluence in the range from about 5 to about 50 mW/cm of light array is delivered to the treatment site.
- the equation discussed above relating energy time and fluence plays a role in selection of the fluence and energy delivered.
- a certain time period may be selected as suitable.
- the nature of treatment might dictate the energy required.
- the light array should be capable of providing that fluence in the allotted time period. For example, if a total of 200 J/cm of light array must be delivered to the treatment site at 20 mW/cm of light array, then the treatment period is approximately 2.8 hours.
- the support member further has a selective coating to control where light transmits to the prostatic tissue thus directing the light activate drug therapy and reducing the potential to treat adjacent tissue.
- the light delivery device is fixed in place in the catheter.
- the light delivery device is movable within the catheter.
- the treatment device may further include printed markings or indicia on the catheter to aid in placement of the light bar within the catheter.
- the light delivery device can also have asymmetric light delivery to protect the colon or rectum.
- the light deliver device can be double sided and/or shielded so that one side of the light bar emits light at a higher intensity than another side. Exemplary light delivery devices are disclosed in U.S. Pat. No. 5,876,427, herein incorporated in its entirety by reference.
- a Y-connection with a leakage control valve is included to allow the light transmission source to be inserted into the catheter through a separate lumen from a urine collection lumen.
- the catheter may include two or more lumens as needed to provide light transmission source manipulation and placement.
- the catheter includes a balloon or other positional element to further aid in positioning the light source transmission end proximate to the prostate using non-incision type methods.
- the catheter may include a retractable fixation device such as balloon, umbrella, tines, disk or other means for fixation and placement within the bladder.
- the light source catheter and/or the light bar may include echogenic material to reflect high-frequency sound waves and thus be imageable by ultrasound techniques. In operation, echogenic material will aid in proper placement of the catheter and the light source.
- the light transmission source also includes temperature sensors which are electrically connected to temperature monitors.
- the prostate treatment systems are expected to provide highly efficient, low cost, and minimally-invasive treatment of prostate conditions.
- the treatment device may be used to treat prostate cancer, prostatis, cystitis, bladder cancer, hypertrophic trigone, and hypertrophic urethral sphincter.
- the present invention utilizes light-activated drug therapy methods to minimally-invasively treat BPH or prostate cancer via the urethra. As a result patients with BPH or prostate cancer can be treated using the present invention without being hospitalized, undergo general anesthesia and blood transfusion, and thus have lower risk of complications.
- the invention also provides methods of administering photoactive therapy to treat targeted tissue of a human or non-human patient.
- the method includes identifying a location of tissue to be treated in the prostate; inserting a catheter into the urethra tract; inserting a light delivery device at least proximate to the location of the targeted tissue; and administering an effective dose of a photoactive drug.
- the method may include confirming placement of the light source prior to treatment.
- the method further includes treating the targeted tissue by activating the light delivery device for a predetermined period of treatment.
- the light-activated drug is mono-L-aspartyl chlorine e 6 , also referred to herein as Talaporfin Sodium.
- compositions and methods of making Talaporfin Sodium are disclosed and taught in co-pending U.S. patent application Ser. No. ______ entitled “Compositions and Methods of Making a Photoactive Agent” filed Jun. 30, 2006, herein incorporated in its entirety.
- This compound has an absorption spectrum that exhibits several peaks, including one with the excitation wavelength of 664 nm, which is the wavelength favored when it is used in photoreactive therapy.
- Alternative light-activated drugs of suitable excitation wavelengths may also be used as is known in the art.
- the method further includes monitoring a temperature at treatment site.
- the temperature measuring system includes a temperature sensor for monitoring the temperature at the treatment site.
- the temperature sensor may be a thermal couple or any suitable device for providing temperature information at the treatment site.
- the temperature sensor may be disposed at the surface of the support member and is further electrically connected to the temperature monitor via wires. Alternatively, the temperature sensor may be wirelessly connected to the temperature monitor.
- the temperature sensor provides the temperature proximate to the treatment site during treatment to ensure safe operating temperatures during the treatment at the treatment site.
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PCT/US2007/001324 WO2007084608A2 (en) | 2006-01-18 | 2007-01-18 | Method and apparatus for light-activated drug therapy |
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US15/091,270 Continuation-In-Part US20160213945A1 (en) | 2003-03-14 | 2016-04-05 | Method and apparatus for treating benign prostatic hyperplasia with light-activated drug therapy |
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US15/406,057 Active US10307610B2 (en) | 2006-01-18 | 2017-01-13 | Method and apparatus for light-activated drug therapy |
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US15/406,057 Active US10307610B2 (en) | 2006-01-18 | 2017-01-13 | Method and apparatus for light-activated drug therapy |
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LT1973598T (lt) | 2018-10-10 |
US20160213945A1 (en) | 2016-07-28 |
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JP2009523549A (ja) | 2009-06-25 |
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WO2007084608A2 (en) | 2007-07-26 |
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WO2007084608A3 (en) | 2008-01-31 |
PL1973598T3 (pl) | 2019-01-31 |
PT1973598T (pt) | 2018-07-05 |
EP1973598A2 (en) | 2008-10-01 |
EP1973598B1 (en) | 2018-05-16 |
CN2885311Y (zh) | 2007-04-04 |
CN101404949A (zh) | 2009-04-08 |
ES2673181T3 (es) | 2018-06-20 |
JP5548849B2 (ja) | 2014-07-16 |
CY1120623T1 (el) | 2019-12-11 |
JP2014087682A (ja) | 2014-05-15 |
CN101404949B (zh) | 2013-07-24 |
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