title: Temoporfin mediated photodynamic therapy in patients with local persistent and recurrent nasopharyngeal carcinoma after curative radiotherapy: a feasibility study.
abstract: BACKGROUND
  The treatment of persistent and recurrent nasopharyngeal carcinoma (NPC) remains a challenge, especially in Indonesia. We investigated the safety and efficacy of temoporfin mediated photodynamic therapy (PDT) for patients with local persistent and recurrent NPC.
  
  
  METHODS
  Twenty-two patients with persistent and recurrent NPC (maximum tumor depth < 10mm) underwent PDT under local anesthesia with use of a nasopharyngeal light applicator. Three different drug doses and light intervals have been administered: treatment arm A: 0.15 mg/kg Foscan; 96 h drug-light interval; B: drug dose of 0.10 mg/, 48 h drug-light interval; C: drug dose of 0.075 mg/kg, 24 h drug-light interval. Toxicity was measured by using the CTCAE 3.1 scale.
  
  
  RESULTS
  Arm A consisted of eight patients, arms B and C consisted of seven patients. The treatment procedure was well tolerable under local anesthesia. The most common grade III toxicities for all groups is headache (n = 7; 33%). No grade IV toxicity was seen. One patient died 2 days after treatment due to a misdiagnosed pneumonia. In 17 of the 22 patients a biopsy was performed after 40 weeks and showed no tumor in all biopsies. Arm A seems, in addition to comparable toxicity, clinically more effective than arms B and C.
  
  
  CONCLUSIONS
  The present study demonstrated that temoporfin mediated photodynamic therapy is a relatively simple technique that can be utilized to treat residual or recurrent nasopharyngeal cancer, restricted locally to the nasopharynx.
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Nyst
authors.forename: M A
authors.initials: MA
authors.lastname: Wildeman
authors.forename: S R
authors.initials: SR
authors.lastname: Indrasari
authors.forename: B
authors.initials: B
authors.lastname: Karakullukcu
authors.forename: R L P
authors.initials: RL
authors.lastname: van Veen
authors.forename: M
authors.initials: M
authors.lastname: Adham
authors.forename: F A
authors.initials: FA
authors.lastname: Stewart
authors.forename: P C
authors.initials: PC
authors.lastname: Levendag
authors.forename: H J C M
authors.initials: HJ
authors.lastname: Sterenborg
authors.forename: I B
authors.initials: IB
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma; D002908:Chronic Disease; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008652:Mesoporphyrins / Q000008:administration & dosage*; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000628:therapy*; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D020266:Radiotherapy, Conformal; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008652:Mesoporphyrins; D017319:Photosensitizing Agents; C072269:temoporfin