Die photodynamische Lasertherapie im Bereich der Hals-, Nasen-, Ohrenheilkunde*

Abstract

A clinical study was conducted on the application of photodynamic therapy on tumours in the head and neck region to assess the value of this new modality for superficial cancer (Tis-T2). Patients with recurrent laryngeal papillomatosis were included in a photodynamic treatment pilot study. 2 mg/kg body weight of haematoporphyrin-derivative (Photosan-3) was administered 48 hours prior to laser irradiation intravenously. The patients rooms were advised to avoid daylight for two to three weeks. Tumours of the facial skin were irradiated homogeneously by means of an optical bench. Directly after laser application we observed an extensive extravasation of the tumour tissue, whereas the surrounding normal tissue showed mild erythema. A dry crust formed subsequently, which disappeared within two weeks associated with re-epithelisation. Mucous membrane tumours showed fibrin layers in the tumour area 24 hours after laser application with selective tumour necrosis. These lesions also epithelised completely within three weeks. Scarring never occurred. Laryngeal tumours as well as laryngeal papillomas were treated by a cylindrical light applicator system and the patients admitted to intensive care unit for 24 hours after laryngoscopy because of risk of laryngeal oedema. 94 patients with tumours of the head and neck with different histological origins were treated photodynamically, as well as 21 patients with laryngeal papillomatosis. Two months after photodynamic laser treatment, controlled biopsies of the former tumour area were performed. 5 patients had a relapse during a maximum follow-up of 4.5 years. This signified a histologically confirmed full response rate of 95%, accompanied by good plastic and functional results.(ABSTRACT TRUNCATED AT 250 WORDS)

Photodynamic therapy on the normal rabbit larynx with phthalocyanine and 5-aminolaevulinic acid induced protoporphyrin IX photosensitisation

“…Photodynamic therapy (PDT) of head and neck tumours has attracted increasing attention over the last ten years, as shown by more than 30 recent clinical publications (Gluckman, 1991;Feyh et al, 1993). However, despite the inherent suitability of PDT for laryngeal tumours, only a few studies have been performed on this organ to date (Gluckmann and Weissler, 1986;Wustrow et al, 1988Wustrow et al, , 1989Abramson et al, 1990Abramson et al, , 1992Feyh et al, 1990;Freche and De Corbiere, 1990; Kleemann, 1990;De Corbiere et al, 1992;Feyh, 1992;Biel, 1994).…”

“…PDT necrosis of squamous cell carcinomas, the most common tumour of the larynx, is well documented (Wustrow et al, 1988(Wustrow et al, , 1989Feyh et al, 1990Feyh et al, , 1993De Corbiere et al, 1992;Biel, 1994). However, for PDT to be of clinical value it is essential for the nature of the damage and subsequent healing of necrosed tumour and necrosed adjacent normal tissues to be fully understood.…”

Photodynamic Diagnosis and Therapy in Dermatology

“…(fig. 3) With systemic photosensitizers 40-100% remission of SCCs could be obtained [38,39,41,42]. In topical ALA-PDT, the CR rate was 60-92% for superficial SCCs [10,14,15,50] and 0-67% for nodular SCCs [10,15,50].…”

Treatment of recurrent respiratory papillomatosis with argon plasma coagulation

“…Various treatment approaches including radiation, ultrasound, vaccines, steroids, podophyllin and levamisol have been tried but have been abandoned (Willging, 1995). Anti-viral drugs such as acyclovir and ribavirin, 13-cis-retionoic acid and photodynamic laser therapy have shown some response but further evaluation is needed (Feyh et al, 1993;Lippmann et al, 1994). Chemotherapeutic drugs have been used but toxic side effects are severe (Mehta and Herold, 1980).…”