title: Transoral robotic photodynamic therapy for the oropharynx.
abstract: Photodynamic therapy (PDT) has been used for head and neck carcinomas with little experience in the oropharynx due to technical challenges in achieving adequate exposure. We present the case of a patient with a second right tonsil carcinoma following previous treatment with transoral robotic surgery (TORS) and postoperative chemoradiation for a left tonsil carcinoma. Repeat TORS for the right tonsil carcinoma reviewed multiple positive surgical margins. The power output from the robotic camera was modified to facilitate safe intraoperative three dimensional visualization of the tumor bed. The robotic arms facilitated clear exposure of the tonsil and tongue base with stable administration of the fluence. Real-time measurements confirmed stable photobleaching with augmentation of the prescribed light fluence secondary to light scatter in the oropharynx. We report a potential new role using TORS for exposure and accurate PDT in the oropharynx.
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA. quon@xrt.upenn.edu
authors.forename: Harry
authors.initials: H
authors.lastname: Quon
authors.forename: Jarod
authors.initials: J
authors.lastname: Finlay
authors.forename: Keith
authors.initials: K
authors.lastname: Cengel
authors.forename: Timothy
authors.initials: T
authors.lastname: Zhu
authors.forename: Bert
authors.initials: B
authors.lastname: O'Malley
authors.forename: Gregory
authors.initials: G
authors.lastname: Weinstein
mesh_terms: D000284:Administration, Oral; D017323:Dihematoporphyrin Ether / Q000627:therapeutic use*; D004360:Drug Therapy, Computer-Assisted / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D012371:Robotics / Q000379:methods*; D014067:Tonsillar Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; D017323:Dihematoporphyrin Ether