Photodynamic therapy for early squamous cell cancer of the upper aerodigestive tract

Photodynamic therapy (PDT) is a treatment modality that results in selective destruction of malignant cells by combining a photosensitizing agent (hematoporphyrin derivative), which is taken up by the cells, and a laser light. This therapeutic modality has been effectively used in managing cancers of the skin, bronchi and bladder. In the head and neck area, however, its use has been confined to the palliation of advanced lesions which have proved refractory to conventional therapy. While this is unquestionably a valid role, its true value, therapeutically, may be in the management of early cancers arising in the upper aerodigestive tract. At the University of Cincinnati, PDT has been used on a variety of such early cancers where, for a variety of reasons, conventional therapy was not possible. A preliminary experience with this modality in managing lesions of the larynx, oral cavity and oropharynx has demonstrated that this is a viable alternative.