Department of Oral and Maxillofacial Surgery, Division of Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Ann Surg Oncol. 2013 Sep;20(9):3076-82. doi: 10.1245/s10434-013-3006-6. Epub 2013 May 19.
mTHPC-mediated photodynamic therapy (PDT) is used for treatment of early head and neck squamous cell carcinoma. This study is a retrospective comparison of PDT with transoral surgery in the treatment of early primary squamous cell carcinoma of the oral cavity/oropharynx.
PDT data were retrieved from four study databases; surgical results were retrieved from our institutional database. To select similar primary tumors, infiltration depth was restricted to 5 mm for the surgery group. A total of 126 T1 and 30 T2 tumors were included in the PDT group, and 58 T1 and 33 T2 tumors were included in the surgically treated group.
Complete response rates with PDT and surgery were 86 and 76% for T1, respectively, and for T2 63 and 78%. Lower local disease-free survival for PDT compared to surgery was found. However, when comparing the need for local retreatment, no significant difference for T1 tumors was found, while for T2 tumors surgery resulted in significantly less need for local retreatment. No significant differences in overall survival between surgery and PDT were observed.
PDT for T1 tumors results in a similar need for retreatment compared to surgery, while for T2 tumors PDT performs worse. Local disease-free survival for surgery is better than for PDT. This may be influenced by the benefit surgery has of having histology available. This allows an early decision on reintervention, while for PDT one has to follow a wait-and-see policy. Future prospective studies should compare efficacy as well as morbidity.
mTHPC 介导的光动力疗法（PDT）用于治疗头颈部早期鳞状细胞癌。本研究是 mTHPC 介导的 PDT 与经口手术治疗口腔/口咽早期原发性鳞状细胞癌的回顾性比较。
PDT 数据从四个研究数据库中检索，手术结果从我们的机构数据库中检索。为了选择相似的原发性肿瘤，手术组将浸润深度限制在 5mm。PDT 组共纳入 126 例 T1 和 30 例 T2 肿瘤，手术组纳入 58 例 T1 和 33 例 T2 肿瘤。
PDT 和手术治疗 T1 肿瘤的完全缓解率分别为 86%和 76%，T2 肿瘤的完全缓解率分别为 63%和 78%。PDT 的局部无病生存率低于手术。然而，当比较局部复发治疗的需求时，T1 肿瘤无显著差异，而 T2 肿瘤手术的局部复发治疗需求明显较少。手术和 PDT 之间的总生存率无显著差异。
PDT 治疗 T1 肿瘤与手术相比需要的再治疗相似，而 T2 肿瘤的 PDT 效果较差。手术的局部无病生存率优于 PDT。这可能受到手术具有组织学的益处的影响。这可以使早期决定再次干预，而 PDT 则需要等待观察的策略。未来的前瞻性研究应比较疗效和发病率。
