Photodynamic therapy with meta-tetrahydroxyphenylchlorin (Foscan®) in the management of squamous cell carcinoma of the head and neck: experience with 35 patients
- 243 Downloads
Photodynamic therapy (PDT) is a relatively new method of treating superficial tumours of the skin and mucosa. After the injection of a photosensitising agent, the tumour area is exposed to non-thermal laser light. This causes a phototoxic reaction, producing oxygen radicals that destroy tumour cells. From November 2003 to July 2007, a total of 35 patients with recurrent squamous cell carcinoma or secondary tumours of the head and neck region were treated with PDT at the German Armed Forces Hospital in Ulm. These patients had failed or found unsuitable for other treatments. Meta-tetrahydroxyphenylchlorin (mTHPC), known under the trade name of Foscan®, was used as the photosensitising agent. Local control was achieved in 21 patients (60%) and partial remission in 10 patients (28.5%). Four patients (11.5%) did not respond to PDT treatment. The mean duration of overall survival was 401.45 (±321.2) days, median was 356 after the completion of treatment. The mean duration of recurrence-free survival was 327.7 (±131.1) days, median was 181 for patients with complete remission. None of the patient developed serious complications. Photodynamic therapy is an important treatment option for patients who present with recurrent carcinoma or secondary tumours of the upper aerodigestive tract and who have failed or unsuitable for other treatments. Due to the excellent treatment results that have been achieved so far, PDT may in the future also play a role in the primary treatment of superficial tumours of the oral cavity, pharynx and larynx.
KeywordsPhotodynamic therapy Foscan mTHPC Head and neck tumours Squamous cell carcinoma
Conflicts of interest
We confirm that there are no financial contributions to the work and no potential conflicts of interest.
- 5.Blant SA, Glanzmann TM, Ballini JP, Wagnieres G, Van den Bergh H, Monnier P (2002) Uptake and localisation of mTHPC (Foscan) and its 14C-labelled form in normal and tumour tissues of the hamster squamous cell carcinoma model: a comparative study. Br J Cancer 87:1470–1478. doi: 10.1038/sj.bjc.6600651 CrossRefPubMedGoogle Scholar
- 10.Dilkes MG, Alusi G, Djaezeri BJ (1999) The treatment of head and neck cancer with photodynamic therapy: clinical experience. Rev Contemp Pharmacother 10:47–57Google Scholar
- 15.Gedlicka C, Formaneck M, Selzer E, Burian M, Kornfehl J, Fiebiger W, Cartellieri M, Marks B, Kornek GV (2002) Phase II study with docetaxel and cisplatin in the treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck. Oncology 63:145–150. doi: 10.1159/000063809 CrossRefPubMedGoogle Scholar
- 18.Hopper C, Niziolb C, Sidhub M (2004) The cost-effectiveness of Foscan mediated photodynamic therapy (Foscan-PDT) compared with extensive palliative surgery and palliative chemotherapy for patients with advanced head and neck cancer in the UK. Oral Oncol 40:372–382. doi: 10.1016/j.oraloncology.2003.09.003 CrossRefPubMedGoogle Scholar
- 27.Steel GG (1997) The growth rate of tumours. In: Steel G (ed) Basic clinical radiobiology, 2nd edn. Arnold, London, pp 9–13Google Scholar
- 28.The European Agency for the Evaluation of Medicinal Products (2001) Foscan: Summary of product characteristicsGoogle Scholar
- 29.Vermorken JB, Mesia R, Rivera F, Remenar E, Kawecki A, Rottey S, Erfan J, Zabolotnyy D, Kienzer H, Cupissol D, Peyrade F, Benasso M, Vynnychenko I, De Raucourt D, Bokemeyer C, Schueler A, Amellal N, Hitt R (2008) Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med 11:1116–1127. doi: 10.1056/NEJMoa0802656 CrossRefGoogle Scholar
- 31.Wheeler RH (1990) Chemotherapy of patients with recurrent head and neck cancer. In: Jacobs C (ed) Carcinomas of the head and neck: evaluation and management. Kluwer, Boston, pp 171–193Google Scholar