Initial experience in the treatment of oral leukoplakia with high-dose vitamin A and follow-up 5-aminolevulinic acid induced protoporphyrin IX fluorescence.
The aim of photodynamic diagnostics is complete visualization of all neoplastic lesions in a tumorous organ after the application of a tumor-selective photosensitizer. We explored the potential benefit of a combination of retinyl palmitate for the treatment of oral leukoplakias and follow-up diagnosis of malignant tissue by using 5-aminolevulinic acid (5-ALA) as a fluorescence marker. Semiquantitative measurements were performed following the topical application of 5-ALA in six patients. After biopsy and histological evaluation of tissue specimens the patients were treated with escalating doses of retinyl palmitate. After treatment periods ranging from 4 to 8 weeks 5-ALA was again applied for photodetection of persisting fluorescence. In all cases prior to retinyl palmitate treatment a prominent red fluorescence indicated tissue dysplasia. Eight weeks after treatment with retinyl palmitate decreased red fluorescence intensities were found, and repeated histological evaluations showed no persistent signs of dysplastic lesions. Our initial experience shows that high doses of retinyl palmitate can be useful for treating dysplastic lesions in the upper aerodigestive tract and can be monitored with 5-ALA induced protoporphyrin IX fluorescence.
Leunig
A
A
Department of Otorhinolaryngology, University of Munich, Klinikum Grosshadern, Germany. Andreas.Leunig@hno.med.uni-muenchen.de
Betz
C S
CS
Baumgartner
R
R
Grevers
G
G
Issing
W J
WJ
D000328:Adult; D000622:Aminolevulinic Acid; D016588:Anticarcinogenic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004224:Diterpenes; D005260:Female; D005453:Fluorescence; D006801:Humans; D007972:Leukoplakia, Oral / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents; D011524:Protoporphyrins; D000084562:Retinyl Esters; D014801:Vitamin A / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000627:therapeutic use
D016588:Anticarcinogenic Agents; D004224:Diterpenes; D017319:Photosensitizing Agents; D011524:Protoporphyrins; D000084562:Retinyl Esters; D014801:Vitamin A; C014794:retinol palmitate; D000622:Aminolevulinic Acid; C028025:protoporphyrin IX