Kulapaditharom B, Boonkitticharoen V
Department of Otolaryngology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2000 Mar;83(3):249-58.
Photodynamic therapy (PDT) is a new form of cancer treatment with low morbidity. In this study, PDT was evaluated for its effectiveness in management of recurrent or widespread precancerous lesions, primary cancers in inoperable sites, recurrent or residual cancers which were refractory to radiotherapy and chemotherapy, and advanced tumors in the head and neck. Fifty-one patients were treated over a period of 5 years. A 91.67 per cent complete response rate was observed for T1 tumors (primary and recurrence) with a recurrent rate of 27.27 per cent. Nasopharyngeal carcinoma was highly responsive to PDT since all T1 and T2 tumors responded completely. This was in contrast to cancers in the soft palate which failed in most cases possibly due to inadequate light dose distribution. PDT was remarkably effective in curing premalignant diseases (100% complete response rate). Postoperative PDT was equally effective in treating the microscopic residual malignancy. For advanced tumors, PDT in adjunct to conventional modalities could induce complete response in 5 out of the 10 patients and resolve symptoms in 4 cases. The mean follow-up time for this series was 28.3 months (range 3-66 months). In conclusion, PDT is a useful modality for the treatment of head and neck tumors and precancerous lesions presenting in forms or under conditions that posed considerable difficulties in management by conventional approaches.
光动力疗法（PDT）是一种发病率较低的新型癌症治疗方法。在本研究中，对光动力疗法在治疗复发性或广泛性癌前病变、无法手术部位的原发性癌症、对放疗和化疗难治的复发性或残留性癌症以及头颈部晚期肿瘤方面的有效性进行了评估。在5年的时间里对51名患者进行了治疗。观察到T1期肿瘤（原发性和复发性）的完全缓解率为91.67%，复发率为27.27%。鼻咽癌对光动力疗法高度敏感，因为所有T1和T2期肿瘤均完全缓解。这与软腭癌形成对比，软腭癌在大多数情况下治疗失败，可能是由于光剂量分布不足。光动力疗法在治愈癌前疾病方面非常有效（完全缓解率为100%）。术后光动力疗法在治疗微小残留恶性肿瘤方面同样有效。对于晚期肿瘤，光动力疗法联合传统治疗方法可使10名患者中的5名完全缓解，4例症状缓解。本系列患者的平均随访时间为28.3个月（范围3 - 66个月）。总之，对于以传统方法治疗存在相当大困难的形式或情况下出现的头颈部肿瘤和癌前病变，光动力疗法是一种有用的治疗方式。
