PHOTOFRIN-mediated photodynamic therapy for treatment of early stage oral cavity and laryngeal malignancies.
OBJECTIVE
To determine the efficacy of PHOTOFRIN-mediated photodynamic therapy (PDT) for treatment of diffuse "field cancerization" of the oral cavity and Cis-T2N0M0 squamous cell carcinoma (SqCCa) of the larynx in patients not amenable or that have failed conventional head and neck treatment.


METHODS
Over the past 15 years 10 patients with early stage Tis-T2N0M0 SqCCa of the oral cavity and oropharynx and 10 patients with Tis-T2N0M0 SqCCa of the larynx were treated. Intravenous PHOTOFRIN (porfimer sodium) (dose 2.0 mg/kg) was administered outpatient, followed 48-60 hours later by intraoperative light photoactivation at 630 nm via fiberoptic microlens (ML) delivery (surgical light dose, 50-100 J/cm(2)) and/or cylindrical diffuser (CD) delivery (80-100 J/cm).


RESULTS
Complete responses (CRs) (follow up 6 months-9 years) were achieved in eight of 10 patients with diffuse field cancerization of the oral cavity. CRs (follow up 6 months-8 years) were achieved in eight of 10 patients with superficial laryngeal cancer obviating the need for total laryngectomy in previously treated radiation therapy patients.


CONCLUSIONS
PHOTOFRIN-mediated PDT provides a surgical oncologic modality for potentially curative treatment of early stage oral cavity and laryngeal malignancies with minimal side effects, absence of systemic toxicity, preservation of oral function and voice quality, with multiple drug administration, and laser light retreatment capability.
Schweitzer
V G
VG
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, 2799 W. Grand Blvd. (K-8), Detroit, MI 48202, USA.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology*; D017323:Dihematoporphyrin Ether / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D007830:Larynx / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D009062:Mouth Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D009367:Neoplasm Staging; D010778:Photochemotherapy; D012189:Retrospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D017323:Dihematoporphyrin Ether