scholarly journals Photodynamic therapy of malignant and premalignant lesions in patients with ’field cancerization‘ of the oral cavity

1993 ◽  
Vol 107 (12) ◽  
pp. 1140-1145 ◽  
Author(s):  
W. E. Grant ◽  
C. Hopper ◽  
P. M. Speight ◽  
A. J. Macrobert ◽  
S. G. Bown
Keyword(s):  
Photodynamic Therapy ◽  
Oral Cavity ◽  
Complete Response ◽  
Premalignant Lesions ◽  
Field Cancerization ◽  
Multiple Primary Cancers ◽  
Upper Aerodigestive Tract ◽  
Multiple Primary ◽  
Considerable Problem

The management of patients with ’field cancerization‘ of the oral mucosa, with multicentric foci of invasion, presents a considerable problem for the head and neck surgeon. Surgical resection of synchronous or metachronous primary squamous cell carcinomas, along with adjacent premalignant lesions, is likely to be associated with considerable mutilation. Photodynamic therapy (PDT) has been shown to be of value in the treatment of superficial tumours in the upper aerodigestive tract, with excellent healing of treated areas. This study reports the use of PDT to treat 11 patients with ’field cancerization‘ occurring in the oral cavity. Six patients had multiple primary cancers and five had single primary tumours. All had associated areas of leukoplakia. Each received Photofrin 2 mg/kg 48 hours prior to photoirradiation with 50–100 J/cm² red laser light by surface illumination. Six to eight weeks later treated areas in 10 of the 11 patients showed a complete response to PDT; one patient had areas of residual leukoplakia. Two patients developed further areas of leukoplakia or erythroplakia within 12 months but no patient has had evidence of recurrent invasive carcinoma in the treated areas. Longer term follow-up will be necessary to exclude further recurrence. It is concluded that PDT offers an effective repeatable treatment option, whether on its own or as an adjunct to local excision, for patients with ’field cancerization‘ of the oral cavity.

scholarly journals Photodynamic Therapy as an Alternative Therapeutic Tool in Functionally Inoperable Oral and Oropharyngeal Carcinoma: A Single Tertiary Center Retrospective Cohort Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Arnaud Lambert ◽  
Lotte Nees ◽  
Sandra Nuyts ◽  
Paul Clement ◽  
Jeroen Meulemans ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Photodynamic Therapy ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Standard Treatment ◽  
Treated Area ◽  
Free Interval

Background: Head and neck cancer is typically treated with surgery, radiotherapy, chemoradiation, or a combination of these treatments. This study aims to retrospectively analyse oncological outcomes, adverse events and toxicity of treatment with temoporfin-mediated photodynamic therapy at a single tertiary referral center. More specifically, in a selected group of patients with otherwise (functionally) inoperable oral or oropharyngeal head and neck squamous cell carcinoma.Methods: Twenty-six consecutive patients who received photodynamic therapy for oral or oropharyngeal squamous cell carcinoma from January 2002 until July 2019 at the University Hospitals Leuven were included. These were (1) patients with an accessible recurrent or new primary tumor in an extensively treated area of the head and neck, not suitable for standard treatment, or (2) patients that were judged medically unfit to undergo standard treatment modalities.Results: Complete tumor response immediately after PDT was obtained in 76.9% of cases. During follow-up, a proportion of CR patients did recur, to reach recurrence-free rates at six months, one year and two years of 60.6%, 48.5% and 32.3%. Local control at the PDT treated area was 42.3% with a median recurrence free interval time of 9 months. Recurrence-free interval was statistically more favorable for oropharyngeal squamous cell carcinoma (with or without oral cavity extension) in comparison to oral cavity squamous cell carcinoma alone (p < 0.001). During a median follow-up period of 27 months, we report new tumor activity in 80.8% of patients. Median overall and disease-specific survival time was 31 and 34 months, respectively. Most reported adverse events were pain after treatment and facial edema. At the end of follow-up, swallowing and upper airway functionality were preserved in 76.9 and 95.7% of patients, respectively.Conclusion: Photodynamic therapy is a valuable treatment option in highly selected patients with oral and/or oropharyngeal (functionally) inoperable head and neck squamous cell carcinoma. Treatment with this alternative modality can induce durable local control in an important fraction of treated patients, with an acceptable toxicity profile.

scholarly journals Photodynamic Therapy of Malignant Brain Tumours

1990 ◽  
Vol 17 (2) ◽  
pp. 193-198 ◽  
Author(s):  
Paul J. Muller ◽  
Brian C. Wilson
Keyword(s):  
Photodynamic Therapy ◽  
Median Survival ◽  
Brain Tumours ◽  
Complete Response ◽  
Tumour Resection ◽  
Malignant Tumours ◽  
Actuarial Survival ◽  
Malignant Brain Tumours ◽  
Actuarial Survival Rate

ABSTRACT:Fifty patients with malignant supratentorial tumours were treated with intra-operative photodynamic therapy (PDT); in 33 cases the tumour was recurrent. In 45 patients the tumour was a cerebral glioma and in 5 cases a solitary cerebral metastasis. All patients received a porphyrin photosensitizer 18-24 hours pre-operatively. Photoillumination was carried out at 630 nm to a tumour cavity created by radical tumour resection and/or tumour cyst drainage. The light energy density ranged from 8 to 175 J/cm2. In 8 patients additional interstitial light was administered. The operative mortality was 4%. Follow up has ranged from 1 to 30 months. The median survival for the 45 primary malignant tumours was 8.6 months with a 1 and 2 year actuarial survival rate of 32% and 18%, respectively. In 12 patients a complete or near complete CT scan response was identified post PDT. These patients tended to have a tumour geometry (eg. cystic) that allowed complete or near complete light distribution to the tumour. The median survival for this group was 17.1 months with a 1 and 2 year actuarial survival of 62% and 38%, respectively. In the 33 cases who did not have a complete response the median survival was 6.5 months with a 1 and 2 year actuarial survival of 22% and 11%, respectively. Photodynamic therapy of malignant brain tumours can be carried out with acceptable risk. Good responses appear to be related to adequate light delivery to the tumour.

Photodynamic therapy for palliation of locally recurrent breast carcinoma.

1987 ◽  
Vol 5 (11) ◽  
pp. 1766-1770 ◽  
Author(s):  
M Schuh ◽  
U O Nseyo ◽  
W R Potter ◽  
T L Dao ◽  
T J Dougherty
Keyword(s):  
Photodynamic Therapy ◽  
Breast Carcinoma ◽  
Chest Wall ◽  
Complete Response ◽  
Chest Wall Recurrence ◽  
Heavily Pretreated ◽  
Locally Recurrent ◽  
Recurrent Breast ◽  
Lost To Follow Up

Fourteen women with locally recurrent breast carcinoma on the chest wall following mastectomy were given 30 courses of photodynamic therapy (PDT). All patients had been heavily pretreated with conventional modes of therapy (radiation therapy, chemotherapy, hormonal therapy, surgical resection). Twenty-two courses yielded a partial response; two courses yielded a complete response; four courses showed no response; one patient was treated as an adjunct to surgery; and one patient was lost to follow-up. Duration to response was variable, ranging from 6 weeks to 8 months. Several women had chest wall disease controlled for prolonged periods of time using repeated courses of PDT. Two women had re-epithelialization of ulcerated lesions. Complications were minimal and included pain (two patients), sunburn (two), and infection (one). These results suggest that treatment with PDT can aid in local control of chest wall recurrence following mastectomy in selected patients.

scholarly journals Long Term Effectiveness of Photodynamic Therapy for CIN Treatment

2019 ◽  
Vol 12 (3) ◽  
pp. 107 ◽  
Author(s):  
Natalia Mayumi Inada ◽  
Hilde Harb Buzzá ◽  
Marieli Fernanda Martins Leite ◽  
Cristina Kurachi ◽  
Jose Roberto Trujillo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Photodynamic Therapy ◽  
Placebo Group ◽  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Complete Response ◽  
Incidence Rates ◽  
South Central

(1) Background: Cervical cancer is the third most commonly diagnosed cancer and the fourth leading cause of cancer death in women worldwide. The highest incidence rates are in Africa, followed by South-Central Asia and South America. According to the Brazilian National Institute of Cancer (INCA), 16,370 new cases of cervical cancer were estimated for each year of the biennium of 2018–2019. About 90% of cervical cancers originate from the malignant progression of cervical intraepithelial neoplasia (CIN) which is classified based on cytohistological characteristics (low- and high-grade lesions). The present study reports the long-term effectiveness of topical photodynamic therapy (PDT) for CIN grades 1 and 2/3 with up to two years of follow up. (2) Methods: A total of 56 patients with CIN 1, ten with CIN 2, and 14 patients for the placebo group were enrolled in this study. (3) Results: 75% (n = 42) of CIN 1 patients presented a complete response to PDT and only 23.2% (n = 13) of recurrence, progression, and/or lesions remaining two years after PDT. For CIN 2/3 patients, 90% were observed to be cured after one and two years of follow up. (4) Conclusions: PDT presented best results two years after a non-invasive, fast, and low-cost procedure and in comparison with the placebo group, preventing the progression of cervical intraepithelial neoplasia and preserving the cervix.

scholarly journals Treatment of cutaneous lichen planus with ALA-mediated topical photodynamic therapy

2015 ◽  
Vol 08 (01) ◽  
pp. 1540004 ◽  
Author(s):  
Zhi-Xia Fan ◽  
Ling-Lin Zhang ◽  
Hong-Wei Wang ◽  
Pei-Ru Wang ◽  
Zheng Huang ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Side Effects ◽  
Lichen Planus ◽  
Clinical Assessment ◽  
Response Rate ◽  
Aminolevulinic Acid ◽  
Complete Response Rate ◽  
Complete Response ◽  
Chinese Patients

Purpose: To evaluate the effectiveness of topical 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) for the treatment of cutaneous lichen planus (LP). Methods: A total of 17 symptomatic LP lesions in 7 Chinese patients were assessed. ALA cream (10%) was applied topically to LP lesions for 3 h. The lesions were irradiated with a 635 nm diode laser at the dose level of 100 J/cm2. The treatment was repeated at two-week intervals. Clinical assessment was conducted before each treatment. Follow-up was performed once a month for up to six months. Results: Lesions showed significant improvement after one to four courses of treatments. Complete response was achieved in 13 lesions (five patients) and partial remission in four lesions (two patients). The complete response rate was 71%. There was no significant side effects except the feeling of pain that most patients could tolerate. Follow-up of five patients who achieved complete response showed no signs of recurrence. Conclusion: Topical ALA PDT is effective in the treatment of cutaneous LP.

Multiple synchronous carcinoma of the aero-digestive tract

1989 ◽  
Vol 103 (8) ◽  
pp. 794-795 ◽  
Author(s):  
Andrew McCombe ◽  
Valerie J. Lund ◽  
David J. Howard
Keyword(s):  
Digestive Tract ◽  
Relevant Literature ◽  
Aerodigestive Tract ◽  
Field Cancerization ◽  
Initial Assessment ◽  
Upper Aerodigestive Tract ◽  
Synchronous Carcinoma ◽  
High Incidence ◽  
Multiple Carcinoma

AbstractMultiple carcinoma of the upper aerodigestive tract is an increasingly recognized problem, and a concept of ‘field cancerization’ has been proposed to explain this phenomena. The initial assessment of a patient with an isolated aerodigestive carcinoma must be extensive so as not to miss any synchronous lesions, and may include radiography and endoscopy. Treatment cannot be standardised but must be tailored to suit individual problems and because of the high incidence of metachronous tumours, follow-up must be both thorough and ‘lifelong’.A case of three primary synchronous squamous carcinomas of the upper aerodigestive tract is presented. The relevant literature is reviewed.

PDT for Tis-T2N0 Oral Cavity and Oropharyngeal Malignancies

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P34-P34
Author(s):  
Vanessa G Schweitzer ◽  
Melissa L Somers
Keyword(s):  
Squamous Cell Carcinoma ◽  
Photodynamic Therapy ◽  
Complete Remission ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Field Cancerization ◽  
Multiple Drug ◽  
Disease Free

Objective To evaluate the efficacy of PHOTOFRIN-mediated photodynamic therapy (PDT) for treatment of diffuse ‘field cancerization’ and Tis-T2N0M0 squamous cell carcinoma (SqCCa) of the oral cavity and oral pharynx in patients not amenable to or that failed conventional head and neck treatment. Methods This is nonrandomized prospective study of 28 patients with field cancerization and early stage Tis-T2N0M0 squamous cell carcinoma of the oral cavity/oropharynx treated with PHOTOFRIN-mediated PDT. Intravenous PHOTOFRIN (porfimer sodium)(dose 2.0 mg/kg) was administered outpatient, followed 48–60 hours later by intraoperative photoactivation at 630nm via fiberoptic microlens surface delivery (surgical light dose 50–100 J/cm2). Results 21 of 27 patients (77%) have demonstrated complete remission (follow-up 1 month to 12 years). There were 5 patients that had partial remission with recurrence observed at 3, 3, 8, 22, and 23 months subsequently retreated with conventional therapy. All locally disease-free individuals were followed up between 1 to 144 months. 14 of the 21 patients in complete remission were disease-free for a period greater than 1 year following photodynamic therapy. Conclusions PHOTOFRIN-mediated photodynamic therapy can be used as a primary modality to treat Tis-T2N0 tumors of the oral cavity and oropharynx or for treatment for those that have failed prior surgery and/or radiation therapy. PDT allows for preservation of function and structure with absence of systemic toxicity, and patients may have multiple drug administrations and laser light retreatments for local disease control.

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