Structural Effects of Photodynamic Therapy and Bisphosphonates on Healthy and Metastatically Involved Vertebral Bone

The vertebral column is the most common site of skeletal metastatic development secondary to breast cancer. Multiple clinical treatments are available for spinal metastasis, including systemic bisphosphonates and radiation therapy, however the success of current treatment approaches varies considerably. Alternative treatment strategies for spinal metastatic destruction must be aimed at both reducing tumor burden and restoring mechanical stability. Photodynamic therapy (PDT) has been shown to be successful at destroying osteolytic lesions in preclinical models of breast cancer spinal metastasis. However, the clinical feasibility of PDT for spinal metastasis is dependent on its potential effects on the structural integrity of vertebral bone. This thesis aims to determine the effects of PDT alone and in combination with bisphosphonate therapy on the structural architecture and mechanical properties of healthy and metastatically involved vertebrae. PDT was shown to have a positive effect on vertebral bone structure, alone and in combination with previous bisphosphonate therapy.