Photodynamic therapy in selected cases at the ENT Clinic, Innsbruck: case reports

Although photodynamic therapy (PDT) for the treatment of head and neck cancer has proved useful in other departments (J. Feyh, A. Goetz and W. Muller, Photodynamic therapy in head and neck surgery, J. Photochem. Photobiol. B: Biol., 7 (1990) 353-358; V.G. Schweitzer, Photodynamic therapy for treatment of head and neck cancer, Arch. Otolaryngol. Head Neck Surg., 102 (1990) 225-232; B.L. Wenig, D.M. Kurtzmann and L.I. Grossweiner, Photodynamic therapy in the treatment of squamous cell carcinomas of the head and neck, Arch. Otolaryngol. Head Neck Surg., 116 (1990) 1267-1270), it is not a standard therapy at the ENT Department of the University Clinic Innsbruck. PDT has only been applied in a few selected cases. Photosan 3 (dihaematoporphyrin either, DHE) was used as photosensitizer at a dose of 2.5 mg (kg body weight)-1 administered intravenously 24-48 h prior to photoirradiation. In one case, Photosan 3 was applied topically in a solution with 40% dimethylsulphoxide (DMSO). The light source was an argon dye laser with a wavelength of 630 nm and a power of 100 mW cm-2, coupled with a cylindrical or spherical applicator and a lens fibre tip. Patients suffering from cancer of the palatine arch, tonsil, nasal septum and glottis are reported. These selected cases had previous treatment (e.g. chemotherapy, percutaneous irradiation and surgery), and PDT was either performed as a palliative treatment for recurrence or in elderly patients to avoid inappropriate extensive and mutilating surgery.