This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Oncology  • Head & Neck Cancer  • Dentistry/ Oral Medicine  • Laryngology/ Speech/ Language Pathology  • Neoplasms of Head & Neck  • Alert me on articles by topic  Social Bookmarking   What's this?

Nestor R. Rigual, MD; Krishnakumar Thankappan, MMBS, MCh; Michele Cooper, RN; Maureen A. Sullivan, DDS; Thomas Dougherty, PhD; Saurin R. Popat, MD; Thom R. Loree, MD; Merrill A. Biel, MD; Barbara Henderson, PhD

Arch Otolaryngol Head Neck Surg. 2009;135(8):784-788.

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/cm² for dysplasia and CIS and 75 J/cm² for 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 Registration  clinicaltrials.gov Identifier: NCT00530088

Author Affiliations: Department of Head and Neck Surgery/Plastic and Reconstructive Surgery (Drs Rigual, Thankappan, Popat, and Loree), Clinical Research Services (Ms Cooper), Photodynamic Therapy Center, Department of Cell Stress Biology (Drs Dougherty and Henderson and Ms Cooper), and Department of Dentistry and Maxillofacial Prosthetics (Dr Sullivan), Roswell Park Cancer Institute, Buffalo, New York; and Ear, Nose, and Throat Specialty Care, Institute of Head and Neck Oncology and Surgery, Minneapolis, Minnesota (Dr Biel).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?