Biel M A
Ear, Nose & Throat SpecialtyCare of Minnesota, Minneapolis 55404, USA.
Laryngoscope. 1998 Sep;108(9):1259-68. doi: 10.1097/00005537-199809000-00001.
To present the theory, technique, and results of photodynamic therapy for the treatment of oral, laryngeal, and head and neck cancers.
Retrospective review of the literature of more than 500 patients with head and neck cancer treated with photodynamic therapy, as well as a retrospective review of the author's 107 patients treated with photodynamic therapy for head and neck neoplasia between 1990 and 1997.
The literature was retrospectively reviewed, as were patient records, and tabulated for age, sex, site, and staging of lesions, with special focus on post-photodynamic therapy treatment outcome, long-term disease-free survival, and complications.
Twenty-five patients with carcinoma in situ and T1 squamous cell carcinoma of the true vocal cord who underwent photodynamic therapy treatment for cure obtained a complete response after a single photodynamic therapy treatment. Only one patient has had recurrence to date, with a cure rate to 79-month follow-up of 95%. Twenty-nine patients with carcinoma in situ and T1 recurrent squamous cell carcinomas of the oral cavity and tongue were treated. All obtained a complete response after a single photodynamic therapy treatment; however, five patients developed local recurrence with follow-up to 70 months, for an 80% cure rate. A review of 217 patients with early squamous cell carcinomas of the head and neck treated with photodynamic therapy in the literature demonstrated an 89.5% complete response rate. The most common complication in these patients was limited prolonged skin photosensitivity without any permanent sequelae.
Photodynamic therapy is effective for treating carcinoma in situ and T1 squamous cell carcinoma of the larynx and oral cavity and may be of benefit as an adjuvant intraoperative treatment of stages III and IV tumors of the head and neck in conjunction with surgery and radiation therapy to improve cure rates. Further controlled studies need to be performed to further demonstrate the effectiveness of photodynamic therapy and the treatment of head and neck cancers.
介绍光动力疗法治疗口腔、喉及头颈癌的理论、技术和结果。
对500余例接受光动力疗法治疗的头颈癌患者的文献进行回顾性分析，并对作者在1990年至1997年间用该疗法治疗的107例头颈肿瘤患者进行回顾性分析。
对文献以及患者记录进行回顾性分析，并按年龄、性别、病变部位和分期进行列表，特别关注光动力疗法后的治疗结果、长期无病生存率和并发症。
25例原位癌和T1期真声带鳞状细胞癌患者接受光动力疗法以根治，单次治疗后获得完全缓解。截至目前仅有1例复发，至79个月随访时治愈率为95%。29例原位癌和口腔及舌部T1期复发性鳞状细胞癌患者接受治疗，单次光动力疗法治疗后均获得完全缓解；然而，5例患者在随访至70个月时出现局部复发，治愈率为80%。对文献中217例接受光动力疗法治疗的头颈早期鳞状细胞癌患者的回顾显示，完全缓解率为89.5%。这些患者最常见的并发症是皮肤光敏性有限延长，无任何永久性后遗症。
光动力疗法对治疗喉和口腔的原位癌和T1期鳞状细胞癌有效，作为头颈III期和IV期肿瘤手术及放疗的辅助术中治疗可能有助于提高治愈率。需要进一步开展对照研究以进一步证明光动力疗法治疗头颈癌的有效性。
