Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, Rua Vergueiro, 235/249 - Liberdade, São Paulo, SP, 01504-001, Brazil.
School of Medicine, Nove de Julho University, UNINOVE, São Paulo, Brazil.
Lasers Med Sci. 2022 Apr;37(3):1441-1470. doi: 10.1007/s10103-021-03462-3. Epub 2021 Dec 2.
This narrative review aimed to evaluate the effectiveness of PDT in early or advanced squamous cell carcinoma of the head and neck (SCCHN). Scopus, MEDLINE/PubMed, and Embase were searched electronically following the PRISMA protocol. Quality assessment was performed according to JBI, NIH, and AMSTAR protocols. The main outcomes evaluated were treatment response, recurrence, survival, and adverse effects. A total of 49 articles met the search criteria: 43 case series, two cohort studies, two prospective before-after clinical trials, one systematic review, and one meta-analysis. Data from 2121 SCCHN patients were included. The response to PDT was variable according to the type of photosensitizer, tumor location, and tumor stage. In general, higher complete responses rated were observed in T1/T2 SCCHN, mainly with mTHPC-mediated PDT. With regard to T3/T4 or advanced SCCHN tumors, there is no compelling evidence suggesting the effectiveness of PDT. Any adverse effects reported were well tolerated by patients. The present review suggests that PDT is a promising treatment modality for early-stage SCCHN. Although there are limitations due to the low level of evidence of the included studies, we believe that the present review could help to design robust clinical trials to determine the efficacy of PDT in SCCHN.
本叙述性综述旨在评估 PDT 在头颈部鳞状细胞癌（SCCHN）早期或晚期的疗效。根据 PRISMA 方案，在 Scopus、MEDLINE/PubMed 和 Embase 上进行电子检索。根据 JBI、NIH 和 AMSTAR 方案进行质量评估。主要评估的结局为治疗反应、复发、生存和不良反应。共检索到 49 篇符合检索条件的文献：43 篇病例系列研究、2 篇队列研究、2 篇前瞻性前后对照临床试验、1 篇系统评价和 1 篇荟萃分析。共纳入 2121 例 SCCHN 患者。根据光敏剂类型、肿瘤部位和肿瘤分期，PDT 的反应性不同。一般来说，在 T1/T2 SCCHN 中观察到更高的完全缓解率，主要与 mTHPC 介导的 PDT 相关。对于 T3/T4 或晚期 SCCHN 肿瘤，尚无确凿证据表明 PDT 的有效性。报告的任何不良反应均被患者耐受。本综述表明，PDT 是早期 SCCHN 的一种有前途的治疗方法。尽管由于纳入研究的证据水平较低存在局限性，但我们相信本综述有助于设计稳健的临床试验，以确定 PDT 在 SCCHN 中的疗效。
