Photodynamic therapy in the management of pre-malignant head and neck mucosal dysplasia and microinvasive carcinoma

Abstract

The management of head and neck mucosal dysplasia and microinvasive carcinoma is an appealing strategy to prevent the development of invasive carcinomas. While surgery remains the standard of care, photodynamic therapy (PDT) offers several advantages including the ability to provide superficial yet wide field mucosal ablative treatment. This is particularly attractive where defining the extent of the dysplasia can be difficult. PDT can also retreat the mucosa without any cumulative fibrotic complications affecting function. To date, clinical experience suggests that this treatment approach can be effective in obtaining a complete response for the treated lesion but long term follow-up is limited. Further research efforts are needed to define not only the risk of malignant transformation with PDT but to develop site specific treatment recommendations that include the fluence, fluence rate and light delivery technique.

Nanoemulsion-templated multilayer nanocapsules for cyanine-type photosensitizer delivery to human breast carcinoma cells

“…Being a minimally invasive clinical procedure, this methodology is considered as a superior alternative to classical therapies such as surgery, radiotherapy and chemotherapy (Quon et al, 2011;Kuruppuarachchi et al, 2011). The PDT approach involves the use photosensitizing agents (or so-called photosensitizers, PSs) with light of a particular wavelength which leads to photoreactions in the neoplastic tissue.…”

Blood flow dynamics during local photoreaction in a head and neck tumor model

“…It is particularly well suited for treatment of head and neck cancers with multiple tumor foci or widespread diseases (e.g., leukoplakia or invasive carcinoma in the oral cavity) [4]. However, PDT responses can vary from ∼90 to ∼45% depending on site, tumor stage and treatment protocols, which has hampered wider clinical use [5][6][7][8].…”

Monitoring PDT response of head and neck lesions with diffuse optical spectroscopies

“…It is especially beneficial for lesions in the oral cavity, where traditional treatments such as surgery, radiation and chemotherapy often harm normal tissue or cause systemic side effects [1][2][3]. Because PDT is a local therapy, there is high preservation of functionality including speech and swallowing as well as fewer systemic side effects leading to an increased quality of life.…”