Department of Dermatology Surgery, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China.
Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University, Shanghai, China.
Photodiagnosis Photodyn Ther. 2020 Dec;32:102043. doi: 10.1016/j.pdpdt.2020.102043. Epub 2020 Oct 1.
Squamous cell carcinoma (SCC) of thelip is conventionally treated by extended surgery or radiotherapy, which may cause deformities and dysfunction due to this special location. Topical 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) for SCC in situ is effective and non-invasive, and may preserve normal morphological structure. However, the effectiveness is limited by tumor size and depth due to the permeability of photosensitizer and penetration depth of the therapeutic light source. We successfully treated two cases of lip invasive SCC (tumor size is 22.4 mm × 16.1 mm × 11.9 mm and 23 mm × 15 mm × 5 mm) with superficial resection surgery to reduce tumor load and sequential ALA-PDT (20 % ALA, 3 h incubation, 200 J/cm) to remove residual tumor. During the treatment, ultrasonography was used to monitor the tumor invasion depth and assess the therapeutic efficacy. Both cases showed tumor free at 12 months of follow-up. These two cases suggest that ALA-PDT combined with minimal invasive surgery is a viable treatment for special cases of lip SCC.
唇鳞状细胞癌（SCC）通常采用扩大手术或放疗治疗，但由于该部位的特殊性，这些治疗方法可能会导致畸形和功能障碍。局部 5-氨基酮戊酸光动力疗法（ALA-PDT）治疗原位 SCC 具有有效性和非侵入性，并且可能保留正常的形态结构。然而，由于光敏剂的通透性和治疗光源的穿透深度，肿瘤大小和深度会限制其疗效。我们成功地对两例唇浸润性 SCC（肿瘤大小为 22.4mm×16.1mm×11.9mm 和 23mm×15mm×5mm）进行了浅表切除术以降低肿瘤负荷，并进行序贯 ALA-PDT（20%ALA，3 小时孵育，200J/cm）以清除残留肿瘤。在治疗过程中，使用超声监测肿瘤侵袭深度并评估治疗效果。两例患者在随访 12 个月时均未见肿瘤。这两例病例提示，ALA-PDT 联合微创外科手术是治疗特殊唇 SCC 的一种可行方法。
