In vivo study of necrosis on the liver tissue of Wistar rats: a combination of photodynamic therapy and carbon dioxide laser ablation

Photodynamic therapy (PDT) is known to be limited to applications in large volume tumors due to its limited penetration. Therefore, a combination of PDT and carbon dioxide (CO2) laser ablation may constitute a potential protocol to destroy bulk tumors because it involves an association of these two techniques allowing the removal of visible lesions with a high selectivity of destruction of remnant tumors. The main aim of this study is to investigate the most appropriate procedure to combine use of a CO2 laser and PDT on livers of healthy rats, and to analyze different techniques of this treatment using three types of photosensitizers (PSs).Forty eight animals were separated to form six groups: (1) only CO2 laser ablation, (2) drug and CO2 laser ablation, (3) only PDT, (4) drug and light (PDT) followed by CO2 laser ablation, (5) ablated with CO2 laser followed by PDT, and (6) drug followed by CO2 laser ablation and light. For each group, three types of photosensitization were used: topical 5-aminolevulinic acid (ALA), intravenous ALA and intravenous Photogem®. Thirty hours after the treatments, the animals were sacrificed and the livers removed. The depth of necrosis was analyzed and measured, considering microscopic and macroscopic aspects. The results show that the effects of the PDT were considerably enhanced when combined with CO2 laser ablation, especially when the PDT was performed before the CO2 laser ablation