title: Photodynamic therapy outcome for oral dysplasia.
abstract: BACKGROUND
  Photodynamic therapy (PDT) is a minimally invasive surgical intervention used in the management of tissue disorders. It can be applied before, or after, any of the conventional modalities, without compromising these treatments or being compromised itself.
  
  
  METHODS
  In this prospective study, a total of 147 consecutive patients with oral potentially malignant disorders were treated with surface illumination PDT, using 5-ALA or mTHPC as the photosensitizer. The average age was 53 ± 8.9 years. The patients' recovery was uneventful and no complications reported. Comparisons with the clinical and histopathological features and rate of recurrence as well as malignant transformation were made. The patients were followed-up for a mean of 7.3 years.
  
  
  RESULTS
  Homogenous leukoplakias were identified in 55 patients, non-homogenous leukoplakias in 73 patients, whereas 19 patients had erythroplakias. Ex- and current lifelong smokers formed 84.4% of the recruited patients. While people who currently smoke and drink formed 38.1% (56 patients) of the cohort. Erythroplakias were mainly identified in heavy lifelong smokers. The most common identified primary anatomical locations were the lateral border of tongue, floor of mouth and retromolar area. Moderate dysplasia was identified in 33 patients while 63 patients had severe dysplasias; and 32 patients had a histopathological diagnosis of carcinoma in situ. The rate of recurrence in laser surgery was approximately 11.6%. Malignant transformation was observed in 11 patients (7.5%), in the tongue, floor of mouth and retromolar area. Recurrence and malignant transformation was mainly identified in erythroplakias and non-homogenous leukoplakias. The final outcome of the cohort showed that 11 (7.5%) suffered from progressive disease, 5 (3.4%) had stable disease, 12 (8.2%) were considered partially responsive to the therapy. Complete response was identified in 119/147 patients (81%).
  
  
  CONCLUSIONS
  5-ALA-PDT and/or mTHPC-PDT offer an effective alternative treatment for oral potentially malignant disorders.
authors.affiliation: UCLH Head and Neck Centre, London, UK. waseem_wk1@yahoo.co.uk
authors.forename: Waseem
authors.initials: W
authors.lastname: Jerjes
authors.forename: Tahwinder
authors.initials: T
authors.lastname: Upile
authors.forename: Zaid
authors.initials: Z
authors.lastname: Hamdoon
authors.forename: Charles Alexander
authors.initials: CA
authors.lastname: Mosse
authors.forename: Sarah
authors.initials: S
authors.lastname: Akram
authors.forename: Colin
authors.initials: C
authors.lastname: Hopper
mesh_terms: D000368:Aged; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D054023:Lasers, Semiconductor / Q000627:therapeutic use; D007972:Leukoplakia, Oral / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D028022:Low-Level Light Therapy; D008297:Male; D008652:Mesoporphyrins / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D008652:Mesoporphyrins; D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid; C072269:temoporfin