Meulemans Jeroen, Delaere Pierre, Vander Poorten Vincent
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Leuven.
Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium.
Curr Opin Otolaryngol Head Neck Surg. 2019 Apr;27(2):136-141. doi: 10.1097/MOO.0000000000000521.
To identify and review the recent literature on clinical applications, outcome, and new developments in photodynamic therapy (PDT) for the treatment of head and neck cancer.
Although PDT and surgery have a similar local control and recurrence rate, the gold standard of treatment for early-stage oral cavity cancer remains local surgery with, on indication, concurrent treatment of the neck. PDT proves its value in treatment of patients with field cancerization and patients with superficial recurrence after previous surgery and/or radiation, in whom surgical salvage would entail important morbidity. PDT is also promising as an adjuvant treatment after surgery in the presence of macroscopic or microscopic involved margins, in patients where reresection or reirradiation would imply an unacceptable risk. Recent progress in the field of PDT focuses on development and clinical application of new photosensitizing agents, photochemical internalization, and photoimmunotherapy.
The value of PDT in specific well-selected head and neck cancer clinical scenarios is well established. The basic research field is rapidly evolving and experimental findings are promising, maybe eventually leading to optimized results, less side-effects, and more indications.
识别并综述近期关于光动力疗法(PDT)治疗头颈癌的临床应用、疗效及新进展的文献。
尽管PDT与手术在局部控制和复发率方面相似,但早期口腔癌的治疗金标准仍是局部手术,并根据指征同时治疗颈部。PDT在治疗场癌化患者以及既往手术和/或放疗后浅表复发的患者中证明了其价值,对于这些患者,手术挽救会带来严重的并发症。在存在宏观或微观切缘受累的情况下,PDT作为手术后的辅助治疗也很有前景,对于再次切除或再次放疗会带来不可接受风险的患者也是如此。PDT领域的最新进展集中在新型光敏剂的开发和临床应用、光化学内化和光免疫治疗。
PDT在特定精心挑选的头颈癌临床场景中的价值已得到充分确立。基础研究领域正在迅速发展,实验结果很有前景,可能最终会带来优化的结果、更少的副作用和更多的适应症。