title: Salvage photodynamic therapy for recurrent nasopharyngeal carcinoma.
abstract: BACKGROUND
  To evaluate the feasibility of photodynamic therapy (NP-PDT) in the palliative management of recurrent/persistent nasopharyngeal cancer (NFC).
  
  
  METHODS
  Six patients with persistent/recurrent NPC underwent PDT with palliative intent. NP-PDT was delivered by three different methods depending on the localization, size and depth of the lesion: type I NP-PDT: transnasal direct illumination of postero-superior recurrence; type II NP-PDT: transnasal direct illumination of the whole nasopharynx; type III NP-PDT: transoral direct or interstitial illumination of lateral recurrence. In this case, the ENT-magnetic navigation system (MNS) was extremely useful in identifying the tumor and its distance from the ICA.
  
  
  RESULTS
  Both patients treated with NP-PDT type I are free from disease at 38 and 71 months after treatment; both patients treated with NP-PDT type II experienced further local and loco-regional recurrence of disease within 16 months; one died of the disease while the second underwent a second palliative treatment, NP-PDT type I, and is currently living with the disease; of the two patients who underwent NP-PDT type III, one died as a result of regional and systemic recurrence without local recurrence while the second experienced a superficial recurrence. He underwent a second NP-PDT type III treatment and is currently free from disease at 21 months.
  
  
  CONCLUSIONS
  NP-PDT is a non-invasive and simple treatment modality that may have an important role in the treatment of selected cases of persistent/recurrent NPC in its early stage, not suitable for a conventional therapeutic protocol. Coupling NP-PDT with the ENT-MNS can be an effective strategy to obtain more precise light delivery within the tumor, particularly in lateral and parapharyngeal localization.
authors: ENT University Department, University of Turin, San Luigi Gonzaga Hospital, Italy. Electronic address: giovannisucco@hotmail.com.
authors: Giovanni
authors: G
authors: Succo
authors: ENT Department, Martini Hospital, Turin, Italy. Electronic address: stefanorosso_1966@libero.it.
authors: S
authors: S
authors: Rosso
authors: ENT University Department, University of Turin, San Luigi Gonzaga Hospital, Italy. Electronic address: gl.fadda@libero.it.
authors: G L
authors: GL
authors: Fadda
authors: ENT University Department, University of Turin, San Luigi Gonzaga Hospital, Italy. Electronic address: marcofantini8811@hotmail.it.
authors: M
authors: M
authors: Fantini
authors: ENT Department, Martini Hospital, Turin, Italy. Electronic address: erikacro73@yahoo.com.
authors: Erika
authors: E
authors: Crosetti
mesh_terms: D002277:Carcinoma; D005260:Female; D006801:Humans; D008297:Male; D008652:Mesoporphyrins / Q000627:therapeutic use*; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000188:drug therapy*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D008652:Mesoporphyrins; D017319:Photosensitizing Agents; C072269:temoporfin
keywords: Magnetic; Nasopharyngeal cancer; Neuronavigator; Photodynamic therapy; Recurrence