Postoperative photodynamic therapy as a new adjuvant treatment after robot-assisted salvage surgery of recurrent squamous cell carcinoma of the base of tongue

Poorten, Vincent Vander; Meulemans, Jeroen; Nuyts, Sandra; Clément, Paul M.; Hermans, Robert; Hauben, Esther; Delaere, Pierre

doi:10.1186/s12957-015-0630-6

Cited by 20 publications

(10 citation statements)

References 7 publications

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“…Adjuvant RT and CRT were administered in 4 (13.3%) and 2 (6.7%) salvage patients, respectively. Two other salvage patients (6.7%) underwent salvage surgery (TLM in one case and total laryngectomy in one case), and two other patients (6.7%) were treated with postoperative PDT because of involved resection margins after TORS procedure for recurrent SCC of the base of tongue after primary RT or CRT ( 22 ). Detailed data on neck dissection and adjuvant strategy for both the up-front and salvage groups are depicted in Tables 2 and 3 .…”

Section: Resultsmentioning

confidence: 99%

Up-front and Salvage Transoral Robotic Surgery for Head and Neck Cancer: A Belgian Multicenter Retrospective Case Series

et al. 2017

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Introduction/aimWe analyzed the functional and oncologic outcomes of primary and salvage transoral robotic surgery (TORS) procedures, performed in three Belgian institutions with a similar philosophy.Patients and methodsA total of 86 patients who underwent TORS between 24-12-2009 and 25-09-2015 were retrospectively reviewed. Descriptive statistics, overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS; Kaplan–Meier), and the variation of these outcomes according to whether patients had primary or salvage TORS were evaluated (univariate log-rank analysis).ResultsOf 86 patients, 56 (65.1%) underwent TORS as a primary treatment and 30 (34.9%) as a salvage procedure for recurrent or second primary cancer. Tumor location was mainly oropharynx (N = 63; 73.3%) followed by supraglottic larynx (N = 11; 12.8%), hypopharynx (N = 11; 12.8%), and glottic larynx (N = 1; 1.2%). In the up-front TORS group, most tumors were classified as cT1 (N = 23; 41.1%)/pT1 (N = 24; 42.9%) or cT2 (N = 27; 48.2%)/pT2 (N = 27; 48.2%) and cN0 (N = 18; 32.1%), cN1 (N = 13; 23.2%), or cN2 (N = 25; 44.6%). In the salvage TORS group, most tumors were cT1-rT1 (N = 18; 60.0%)/pT1-rpT1 (N = 18; 60.0%) or cT2-rT2 (N = 12; 40.0%)/pT2-rpT2 (N = 7; 23.3%) and cN0 (N = 25; 83.3%). Neck dissection was performed in 87.5% of primary cases and 30.0% of salvage cases. In the up-front TORS group, patients were postoperatively submitted to follow-up (N = 13; 23.2%) or received adjuvant radiotherapy, either as single modality (N = 26; 46.4%) or with concomitant cisplatin (N = 15; 26.8%). On the other hand, most salvage TORS patients did not receive any adjuvant therapy (N = 19; 63.3%). Mean and median follow-up was 23.1 and 21.2 months, respectively. Functional results were excellent (no definitive tracheostomy, long-term tube feeding in 1.8% of primary cases, and 20% of salvage cases). In the up-front TORS group, estimated 2-year OS was 88.5% (SE = 5.0%), 2-year DSS was 91.8% (SE = 4.6%) and 2-year DFS was 86.1% (SE = 5.3%). In the salvage TORS group, estimated 2-year OS was 73.5% (SE = 10.9%), 2-year DSS was 93.3% (SE = 6.4%), and 2-year DFS was 75.8% (SE = 9.7%). Comparing outcome of primarily treated patients to salvage patients, a non-statistically significant trend toward better OS (p = 0.262) and DFS (p = 0.139) was observed.ConclusionThis retrospective study confirms favorable oncologic and functional outcomes of TORS for selected head and neck malignancies, both in the primary and in the salvage setting.

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Section: Resultsmentioning

confidence: 99%

Up-front and Salvage Transoral Robotic Surgery for Head and Neck Cancer: A Belgian Multicenter Retrospective Case Series

et al. 2017

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“…Compared to CT or RT, PDT often proves to be an effective, safe alternative with lower morbidity as can be seen in the trials discussed earlier. When PDT is used as salvage treatment after failed RCT, often cases of CR are reported indicating PDT at times is even more effective [ 167 , 168 , 211 ]. Together with the significantly lower morbidity of PDT and the possibility of combining it with RT and CT, this suggests PDT should be considered as a viable alternative.…”

Section: Discussionmentioning

confidence: 99%

“…A recent report describes a small but impressive study investigating the use of mTHPC-PDT for the treatment of recurrent SCC of the base of tongue after salvage surgery following (chemo-) radiation failure. The two patients treated were disease free after 24 and 42 months follow-up [ 211 ]. mTHPC-PDT has also been shown to be a safe adjuvant therapy for recurrent malignant tumors of the paranasal sinuses and recurrent sino-nasal skull base tumors [ 212 , 213 ].…”

Section: Pdt In Clinical Trialsmentioning

confidence: 99%

Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions

Straten

Mashayekhi

Bruijn

et al. 2017

Cancers

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Photodynamic therapy (PDT) is a clinically approved cancer therapy, based on a photochemical reaction between a light activatable molecule or photosensitizer, light, and molecular oxygen. When these three harmless components are present together, reactive oxygen species are formed. These can directly damage cells and/or vasculature, and induce inflammatory and immune responses. PDT is a two-stage procedure, which starts with photosensitizer administration followed by a locally directed light exposure, with the aim of confined tumor destruction. Since its regulatory approval, over 30 years ago, PDT has been the subject of numerous studies and has proven to be an effective form of cancer therapy. This review provides an overview of the clinical trials conducted over the last 10 years, illustrating how PDT is applied in the clinic today. Furthermore, examples from ongoing clinical trials and the most recent preclinical studies are presented, to show the directions, in which PDT is headed, in the near and distant future. Despite the clinical success reported, PDT is still currently underutilized in the clinic. We also discuss the factors that hamper the exploration of this effective therapy and what should be changed to render it a more effective and more widely available option for patients.

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“…The combined strategy can be conducted in different procedures: neoadjuvant PDT can efficiently destroy malignant tissues, thereby enhancing resectability or reducing the required resection extent 106 ; intraoperative PDT denotes the irradiation of the resection cavity with a proper wavelength during or after surgery 107 ; and postoperative PDT is conducted after suture of the incision. 108 The clinical data suggested that a combined strategy could more beneficial to patients with cancer than surgery alone. Neoadjuvant PDT along with chemotherapy has been shown to be effective and safe to facilitate the conversion of surgical candidates in locally advanced non-small cell lung cancer.…”

Section: The Combination Of Fgs With Pdtmentioning

confidence: 99%

Combination of Fluorescence-Guided Surgery With Photodynamic Therapy for the Treatment of Cancer

et al. 2017

Mol Imaging

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Specific visualization of body parts is needed during surgery. Fluorescence-guided surgery (FGS) uses a fluorescence contrast agent for in vivo tumor imaging to detect and identify both malignant and normal tissues. There are several advantages and clinical benefits of FGS over other conventional medical imaging modalities, such as its safety, effectiveness, and suitability for real-time imaging in the operating room. Recent advancements in contrast agents and intraoperative fluorescence imaging devices have led to a greater potential for intraoperative fluorescence imaging in clinical applications. Photodynamic therapy (PDT) is an alternative modality to treat tumors, which uses a light-sensitive drug (photosensitizers) and special light to destroy the targeted tissues. In this review, we discuss the fluorescent contrast agents, some newly developed imaging devices, and the successful clinical application of FGS. Additionally, we present the combined strategy of FGS with PDT to further improve the therapeutic effect for patients with cancer. Taken together, this review provides a unique perspective and summarization of FGS.

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Postoperative photodynamic therapy as a new adjuvant treatment after robot-assisted salvage surgery of recurrent squamous cell carcinoma of the base of tongue

Cited by 20 publications

References 7 publications

Up-front and Salvage Transoral Robotic Surgery for Head and Neck Cancer: A Belgian Multicenter Retrospective Case Series

Up-front and Salvage Transoral Robotic Surgery for Head and Neck Cancer: A Belgian Multicenter Retrospective Case Series

Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions

Combination of Fluorescence-Guided Surgery With Photodynamic Therapy for the Treatment of Cancer

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