Treatment outcome of Photofrin-based photodynamic therapy for T1 and T2 oral squamous cell carcinoma and dysplasia.

Abstract

BACKGROUND:

Photodynamic therapy (PDT) is a minimally invasive treatment modality for early and superficial malignancy or premalignancy in the head and neck regions. However, few studies have examined the use of Photofrin-mediated PDT to manage early carcinoma and dysplasia in the oral cavity.

METHODS:

Between January 2004 and November 2008, 25 T1 to T2 patients with N0 oral squamous cell carcinoma and mucosal dysplasia in the oral cavity were treated by Porfimer sodium (Photofrin(®))-mediated PDT at Nagasaki University Hospital. Clinical responses were evaluated according to the guidelines of the Response Evaluation Criteria in Solid Tumors (RECIST). After the PDT and a 2-year follow-up period, disease specific survival rates were then calculated.

RESULTS:

A total of 30 regions in 25 patients (18 with squamous cell carcinoma and 7 with epithelial dysplasia with hyperkeratosis in the oral cavity) were treated by PDT. Complete response was achieved in 24 of the 25 patients (96%), with a partial response found in the remaining patient. For the three patients who exhibited recurrence at 4, 5, and 15 months after PDT, salvage surgery or a second PDT was performed. Of these three patients, one died due to another disease, while one died due to local lymphatic metastasis that occurred during the follow-up period. Overall, the disease specific survival rate was 95.8%. Treatment-related edema and pain emerged within 24h after irradiation. Pain control using non-steroid anti-inflammatory drugs and opiates was required for 3-4 weeks in all patients. Complete healing was attained at 4-6 weeks after the treatment. No persistent problems related to functional or esthetic outcomes were noted.

• Authors: Hisazumi Ikeda, Takayoshi Tobita, Seigo Ohba, Masataka Uehara, Izumi Asahina
• Journal: Photodiagnosis and photodynamic therapy (Photodiagnosis Photodyn Ther) Vol. 10 Issue 3 Pg. 229-35 (Sep 2013) ISSN: 1873-1597 [Electronic] Netherlands
• PMID: 23993848 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright © 2013 Elsevier B.V. All rights reserved.

Chemical References

• Photosensitizing Agents
• Dihematoporphyrin Ether

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma in Situ (diagnosis, drug therapy)
• Carcinoma, Squamous Cell (diagnosis, drug therapy)
• Dihematoporphyrin Ether (therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Mouth Neoplasms (diagnosis, drug therapy)
• Photochemotherapy (methods)
• Photosensitizing Agents (therapeutic use)
• Survival Rate
• Treatment Outcome