Abstract
The standard treatment for early stage oral cancer is surgery with or without adjuvant radiotherapy. For some patients such treatments are not applicable, for example when adequate re-irradiation doses cannot be given due to previous therapy or when further surgery would be expected to lead to unacceptable functional morbidity. Photodynamic therapy (PDT) might be an alternative for these patients. PDT is based on the interaction of three essential components: a photosensitizer i.e. a light sensitive drug, light and oxygen. The photosensitive drug is initially not toxic, but if activated by light it can interact with oxygen resulting in the formation of highly reactive oxygen species. Reactive oxygen species can readily oxidize biomolecules leading to cell death. The penetration depth of red laser light in tissue is limited to about ~8–10 mm depending on the optical properties in the tissue.
Light can be delivered by surface or, intraluminal illumination for superficial tumors and by interstitial illumination for sub mucosal bulky tumor masses. For interstitial illumination light emitting catheters are inserted directly into the tumor tissue, ensuring the possibility to treat thicker tumors. Good, curative results have been achieved in the treatment of early stage oral cancer. The results are comparable to surgery. Also, in the palliative setting, encouraging results have been achieved, with preservation of quality of life. With surface illumination the treatment has a low morbidity on the long term with good functional and cosmetic results.
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References
Karakullukcu B, Stoker SD, Wildeman APE, Copper MP, Wildeman MA, Tan IB. A matched cohort comparison of mTHPC-mediated photodynamic therapy and trans-oral surgery of early stage oral cavity squamous cell cancer. Eur Arch Otorhinolaryngol. 2013;270(3):1093–7. https://doi.org/10.1007/s00405-012-2104-6.
Dilkes MG, Benjamin E, Ovaisi S, Banerjee AS. Treatment of primary mucosal head and neck squamous cell carcinoma using photodynamic therapy: results after 25 treated cases. J Laryngol Otol. 2003;117(9):713–7.
Lorenz KJ, Maier H. Photodynamic therapy with meta-tetrahydroxyphenylchlorin (Foscan) in the management of squamous cell carcinoma of the head and neck: experience with 35 patients. Eur Arch Otorhinolaryngol. 2009;266(12):1937–44.
Biel MA. Photodynamic therapy treatment of early oral and laryngeal cancers. Photochem Photobiol. 2007;83(5):1063–8.
D’Cruz AK, Robinson MH, Biel MA. mTHPC-mediated photodynamic therapy in patients with advanced, incurable head and neck cancer: a multicenter study of 128 patients. Head Neck. 2004;26(3):232–40.
Nyst HJ, Tan IB, Stewart FA, Balm AJ. Is photodynamic therapy a good alternative to surgery and radiotherapy in the treatment of head and neck cancer? Photodiagn Photodyn Ther. 2009;6(1):3–11.
Karakullukcu B, van Oudenaarde K, Copper MP, et al. Photodynamic therapy of early stage oral cavity and oropharynx neoplasms: an outcome analysis of 170 patients. Eur Arch Otorhinolaryngol. 2011;268(2):281–8.
Hopper C, Kubler A, Lewis H, Tan IB, Putnam G. mTHPC-mediated photodynamic therapy for early oral squamous cell carcinoma. Int J Cancer. 2004;111(1):138–46.
Tan IB, Dolivet G, Ceruse P, Vander Poorten V, Roest G, Rauschning W. Temoporfin-mediated photodynamic therapy in patients with advanced, incurable head and neck cancer: a multicenter study. Head Neck. 2010;32:1597–604.
De Visscher SA, Melchers LJ, Dijkstra PU, et al. mTHPC-mediated photodynamic therapy of early stage oral squamous cell carcinoma: a comparison to surgical treatment. Ann Surg Oncol. 2013;20:3076–82.
Van Veen R, Robinson D, Sterenborg H, et al. Treatment planning for Interstitial Photodynamic Therapy for head and neck cancer. Head Neck Oncol. 2010;2(Suppl 1):O45.
Karakullukcu B, Nyst HJ, van Veen RL, et al. mTHPC mediated interstitial photodynamic therapy of recurrent non-metastatic base of tongue cancers: development of a new method. Head Neck. 2012;34(11):1597–606.
Nyst HJ, van Veen RL, Tan IB, et al. Performance of a dedicated light delivery and dosimetry device for photodynamic therapy of nasopharyngeal carcinoma: phantom and volunteer experiments. Lasers Surg Med. 2007;39(8):647–53.
Ferris RL, Blumenschein G, Fayette J, et al. Nivolumab for recurrent squamous-cell carcinoma of the head and neck. N Engl J Med. 2016;375:1856–67.
Argiris A, Li Y, Forastiere A. Prognostic factors and long-term survivorship in patients with recurrent or metastatic carcinoma of the head and neck. Cancer. 2004;101:2222–9.
Seiwert TY, Burtness B, Mehra R, et al. Safety and clinical activity of pembrolizumab for treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-012): an open-label, multicentre, phase 1b trial. Lancet Oncol. 2016;17:956–65.
Maeding N, Verwanger T, Krammer B. Boosting tumor-specific immunity using PDT. Cancers. 2016;8(10):E91.
Yang Y, Hu Y. Targeting antitumor immune response for enhancing the efficacy of photodynamic therapy of cancer: recent advances and future perspectives. Oxid Med Cell Longev. 2016;2016:5274084.
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Tan, I.B., Stoker, S.D., van Veen, R.L.P. (2018). Alternative Local Treatment in Oral Cavity Cancer: Photodynamic Therapy. In: Vermorken, J., Budach, V., Leemans, C., Machiels, JP., Nicolai, P., O'Sullivan, B. (eds) Critical Issues in Head and Neck Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-98854-2_9
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DOI: https://doi.org/10.1007/978-3-319-98854-2_9
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