The effectiveness of intraoperative photodynamic therapy in the complex treatment of stage III and IV nephroblastoma in children

Nowadays, the problem of malignant neoplasms management remains a priority task. To achieve further progress in cancer treatment, it is necessary to focus on existing but still undervalued methods. One of these approaches is photodynamic therapy (PDT), which can be used in combination with surgery as well as with other antitumor drugs without any risk of inducing cross-resistance. Being miner invasive and selective in tumor targeting, and having no risk of complications, the technique is attractive for application in oncologic pediatrics as an innovation capable of expanding the range of therapeutic techniques. The aim of the study was to investigate the effectiveness of intraoperative photodynamic therapy in children with stage III–IV nephroblastoma. The study included 66 patients aged 0–11 years with stage III and IV nephroblastoma. The patients of the control group (35 children) underwent surgical treatment in combination with chemotherapy and radiation therapy according to the SIOP protocol. The patients of the main group (31 children) underwent therapy according to the SIOP protocol, but in combination with intraoperative PDT. The 5-year survival rate in the main group was 90.3%, in the control group – 71.4% (p = 0.05). The recurrence rate in the main group was 9.7%, in the control group – 11.4%. Thus, high therapeutic efficacy of PDT during intraoperative irradiation of the tumor bed after its removal has been demonstrated. The technique contributes to the increased survival rate of patients with retroperitoneal tumors, which is a promising method to be used in pediatric oncological practice.