PHOTOFRIN-mediated photodynamic therapy for treatment of early stage (Tis-T2N0M0) SqCCa of oral cavity and oropharynx.

OBJECTIVES

To evaluate the efficacy of dihematoporphyrin ether (PHOTOFRIN)-mediated photodynamic therapy (PDT) for the treatment of diffuse field cancerization and Tis-T2N0M0 squamous cell carcinoma (SqCCA) of the oral cavity and oropharynx in patients not amenable to or that have failed conventional head and neck cancer treatment.

METHODS

This is a retrospective study of 30 patients with Tis-T2N0M0 SqCCA of the oral cavity/oropharynx treated with PDT. Intravenous PHOTOFRIN (porfimer sodium) (dose 2.0 mg/kg) was administered outpatient, followed 48-60 hours later by intraoperative photoactivation at 630 nm via fiberoptic microlens surface delivery (light dose 50-100 J/cm(2)) or interstitial implantation via cylindrical diffuser fiberoptic delivery (light dose 50-100 J/cm).

RESULTS

Twenty-four of 30 patients (80%) have demonstrated complete remission (follow-up 3-144 months). There were six patients who had partial remission with recurrence observed at 3, 3, 5, 9, 23, and 26 months subsequently retreated with conventional therapy. Eleven of 24 patients were cancer disease free at 2 years following PDT.

CONCLUSION

PDT provides a surgical oncologic modality for potentially curative treatment of early stage oral cavity and oropharyngeal malignancies either as a primary modality or for treatment in patients that have previously failed surgery and/or radiation therapy.