NDLI: Photodynamic Therapy for Head and Neck Dysplasia and Cancer

Content Provider	JAMA Network
Author	Rigual, Nestor R. Thankappan, Krishnakumar Cooper, Michele Sullivan, Maureen A. Dougherty, Thomas Popat, Saurin R. Loree, Thom R. Biel, Merrill A. Henderson, Barbara
Copyright Year	2009
Abstract	Objective: To determine the response of dysplasia, carcinoma in situ ( CIS), and T1 carcinoma of the oral cavity and larynx to photodynamic therapy with porfimer sodium. Design: Prospective trial. Setting: A National Cancer Institute–designated cancer institute. Patients: Patients with primary or recurrent moderate to severe oral or laryngeal dysplasia, CIS, or T1N0 carcinoma. Intervention: Porfimer sodium, 2 mg/kg of body weight, was injected intravenously 48 hours before treatment. Light at 630 nm for photosensitizer activation was delivered from an argon laser or diode laser using lens or cylindrical diffuser fibers. The light dose was 50 J/cm2for dysplasia and CIS and 75 J/cm2for carcinoma. Main Outcome Measures: Response was evaluated at 1 week and at 1 month and then at 3-month intervals thereafter. Response options were complete ( CR), partial ( PR), and no ( NR) response. Posttreatment biopsies were performed in all patients with persistent and recurrent visible lesions. Results: Thirty patients were enrolled, and 26 were evaluable. Mean follow-up was 15 months (range, 7-52 months). Twenty-four patients had a CR, 1 had a PR, and 1 had NR. Three patients with oral dysplasia with an initial CR experienced recurrence in the treatment field. All the patients with NR, a PR, or recurrence after an initial CR underwent salvage treatment. Temporary morbidities included edema, pain, hoarseness, and skin phototoxicity. Conclusion: Photodynamic therapy with porfimer sodium is an effective treatment alternative, with no permanent sequelae, for oral and laryngeal dysplasia and early carcinoma. Trial Registrationclinicaltrials.gov Identifier: NCT00530088
Ending Page	788
Starting Page	784
Page Count	5
File Format	PDF HTM / HTML
ISSN	08864470
DOI	10.1001/archoto.2009.98
Issue Number	8
Journal	Archives of Otolaryngology–Head & Neck Surgery
Volume Number	135
Language	English
Publisher	American Medical Association
Publisher Date	2009-08-17
Access Restriction	Open
Subject Keyword	cancer neck photochemotherapy head and neck dysplasia mouth dihematoporphyrin ether larynx pain photosensitizing agents carcinoma hoarseness edema follow-up biopsy laryngeal dysplasia phototoxicity carcinoma in situ
Content Type	Text
Resource Type	Article
Subject	Otorhinolaryngology Surgery

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