Photodynamic therapy in the upper aerodigestive tract. Overview and outlook

Abstract

The gold standard in the treatment of (pre)malignancies of the upper aerodigestive tract (UADT) is either surgery or (chemo)radiotherapy. Nevertheless, there are special indications where an alternative treatment, such as photodynamic therapy (PDT), might be as effective for and better tolerated by the patients concerned. This article aims to present a contemporary and comprehensive review on the role of photodynamic therapy in the treatment of (pre)malignancies of the UADT. PubMed was searched for "photodynamic therapy larynx/oral cavity/oropharynx/head and neck" in 01/2016. PDT can be efficient in the treatment of recurrent, residual or multiple carcinomas of the UADT without other treatment options. It has also been used with success in the treatment of early oral or laryngeal carcinomas, widespread precancerous lesions or "difficult-to-treat" skin cancer, even though these treatments are off-label. For now, unsolved scientific and economical challenges hinder the methods spread. In special cases, PDT is a highly effective method to treat head and neck (pre)malignancies. Nevertheless, further clinical studies are needed to better define its true value in head and neck oncology.

Photodynamic therapy for solid tumors: A review of the literature

“…Third‐generation agents are those conjugated with carrier molecules such as antibodies directed against tumor antigens, liposomes and other biomolecules that carry the photosensitizer into the cell, or receptor‐positive sites on the tumor cell surface that lead to more selective accumulation of the photosensitizer molecule within the tumor cells, resulting in more selective targeting and sparing of healthy tissue . Photosensitizers that allow photochemical internalization and release of macromolecules into the cytosol via endocytic vesicles have also been proposed . Whereas the US Food and Drug Administration has approved only a few PDT sensitizers for certain indications, broader approval exists in other countries such as Canada, Japan, and the Netherlands …”

“…10 Photosensitizers that allow photochemical internalization and release of macromolecules into the cytosol via endocytic vesicles have also been proposed. 11,12 Whereas the US Food and Drug Administration has approved only a few PDT sensitizers for certain indications, 13 broader approval exists in other countries such as Canada, Japan, and the Netherlands. 14,15…”

A Comprehensive Review of Various Therapeutic Strategies for the Management of Skin Cancer

“…Third-generation agents are attached to carrier molecules like antibodies directed against tumor antigens, liposomes, and other biomolecules that allow the PS to enter the cell or receptor-positive surfaces on tumor cells and allow the PS to accumulate more specifically within the tumor cells, allowing for more precise targeting while sparing healthy tissue . Additionally, endocystic vesicles that release macromolecules into the cytosol through photochemical interfinalization and PSs have been proposed . Only a few PDT sensitizers have received approval from various nations like Japan, the Netherlands, and Canada, in contrast to the US Food and Drug Administration, which has only approved them for a small number of specific indications .…”

“… 218 Additionally, endocystic vesicles that release macromolecules into the cytosol through photochemical interfinalization and PSs have been proposed. 219 Only a few PDT sensitizers have received approval from various nations like Japan, the Netherlands, and Canada, in contrast to the US Food and Drug Administration, which has only approved them for a small number of specific indications. 220 PDT has been carried out by a variety of light sources like daylight, lasers, laser-emitting diodes, and incandescent light.…”

Adjuvant photodynamic therapy in head and neck cancer after tumor‐positive resection margins

“…The mainstay treatment of head and neck tumors currently consist of surgery, (chemo)radiotherapy, or a combination of these . Photodynamic therapy (PDT) is reported as a treatment modality for head and neck tumors in curative or palliative settings . PDT is registered in Europe for the treatment of recurrent head and neck cancer.…”