Interstitial photodynamic therapy as salvage treatment for recurrent head and neck cancer
Journal
British Journal of Cancer
Journal Volume
91
Journal Issue
3
Pages
441-446
Date Issued
2004
Author(s)
Abstract
Interstitial photodynamic therapy (IPDT) is a technique for applying photodynamic therapy (PDT) to internal tumours using light delivered via fibres inserted percutaneously. This phase I-II study assessed the safety and efficacy of IPDT for patients with persistent or recurrent head and neck cancer unsuitable for further treatment with surgery, radiotherapy or chemotherapy, recruited for 'last hope' salvage treatment. Patients were sensitised with 0.15 mg kg-1 mTHPC (meso-tetrahydroxyphenyl chlorin) 4 days prior to light delivery from fibres inserted directly into the target tumour (20J per site at 652 nm) under image guidance. In all, 45 patients were treated. Nine achieved a complete response. Five are alive and free of disease 10-60 months later. Symptomatic relief (mainly for bleeding, pain or tumour debulking) was achieved in a further 24. The median survival (Kaplan-Meier) was 16 months for the 33 responders, but only 2 months for the 12 nonresponders. The only serious complication was a carotid blow out 2 weeks after PDT. No loss of function was detected in nerves encased by treated tumours. Interstitial photodynamic therapy provides worthwhile palliation with few complications and occasional long-term survivors for otherwise untreatable advanced head and neck cancers. It is a treatment option worth adding to those available to integrated head and neck oncology teams. ? 2004 Cancer Research UK.
Subjects
Interstitial therapy; Photodynamic therapy; Recurrent head and neck cancer
SDGs
Other Subjects
benzene derivative; tetrahydroxyphenylchlorin; unclassified drug; adolescent; adult; aged; article; bleeding; cancer chemotherapy; cancer radiotherapy; cancer recurrence; cancer surgery; cancer survival; cancer therapy; clinical trial; female; head and neck cancer; human; Kaplan Meier method; male; nerve function; pain; palliative therapy; photodynamic therapy; priority journal; radioisotope therapy; school child; Adolescent; Adult; Aged; Aged, 80 and over; Child; Disease-Free Survival; Female; Head and Neck Neoplasms; Humans; Male; Mesoporphyrins; Middle Aged; Palliative Care; Photochemotherapy; Photosensitizing Agents; Salvage Therapy; Treatment Outcome
Type
journal article