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Hematoporphyrin photodynamic therapy: is there truly a future in head and neck oncology? Reflections on a 5-year
1Department of Otolaryngology and Maxillofacial Surgery, University of Cincinnati Medical Center 45267-0528.
Abstract:
Photodynamic therapy, which consists of the selective destruction of tumors using a combination of a photosensitizer administered systemically (dihematoporphyrin ether) and an argon dye-pumped laser, has provoked profound interest amongst oncologists and has particularly titillated head and neck oncologists with its potential. Unfortunately, no multi-institutional trials for head and neck tumors have been introduced, and the literature is replete with anecdotal reports from individual researchers on the management of advanced cancers for palliation, superficial early cancers, and field cancerization of the mucosa ("condemned mucosa"). A personal 5-year experience with 41 head and neck cancers was reviewed, as was the current literature. An attempt was made to place in perspective the true role and future direction of this technology.
Insights
Photodynamic therapy shows promise for head and neck cancers. Further multi-institutional trials are needed to establish its role in treating various stages of head and neck tumors.
Area of Science:
- Oncology
- Photodynamic Therapy
Background:
- Photodynamic therapy (PDT) uses a photosensitizer and laser for tumor destruction.
- PDT has generated significant interest in oncology, especially for head and neck cancers.
Purpose of the Study:
- To review the personal 5-year experience with 41 head and neck cancers treated with PDT.
- To evaluate the current literature and define the role and future of PDT in head and neck oncology.
Main Methods:
- Systemic administration of dihematoporphyrin ether as a photosensitizer.
- Treatment with an argon dye-pumped laser for tumor destruction.
- Review of personal case data and existing literature on PDT for head and neck cancers.
Main Results:
- Anecdotal reports exist for palliation of advanced cancers, early superficial cancers, and "condemned mucosa."
- No multi-institutional trials for head and neck tumors have been reported.
- A personal series of 41 head and neck cancer cases was analyzed.
Conclusions:
- PDT demonstrates potential for head and neck cancer treatment.
- Further multi-institutional trials are essential to validate PDT's efficacy and establish its clinical role.
- The technology's future direction requires further investigation and standardization.