Vocal Fold Vibration After Photofrin-Mediated Photodynamic Therapy for Treatment of Early-Stage Laryngeal Malignancies

Silbergleit, Allen; Somers, Melissa L.; Schweitzer, Vanessa G.; Gardner, Glendon M.; Peterson, Ed

doi:10.1016/j.jvoice.2013.07.010

Cited by 10 publications

(19 citation statements)

References 16 publications

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“…Noteworthy, in several patients there was no damage to the mucosal wave of the vocal folds, suggesting that the voice quality can be preserved. This finding is in agreement with another study reporting that PDT can preserve the voice quality . The minimal long‐term AE is also in agreement with the good healing that was observed at the treatment site (Figures C and C).…”

Section: Discussionsupporting

confidence: 92%

“…Photodynamic therapy (PDT) is a minimally invasive treatment that involves the activation by light of a drug (photosensitizer) that generates cytotoxic reactive oxygen species, resulting in tumor destruction. Several studies suggest that PDT can be used for the treatment of early stage laryngeal cancer . For early‐stage glottic cancer, endoscopic laser resection and radiotherapy (RT) are considered standard treatments and several recent meta‐analyses have shown them to produce excellent and comparable outcomes in local control and functional preservation of the larynx .…”

Section: Introductionmentioning

confidence: 99%

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Photodynamic therapy with 3‐(1′‐hexyloxyethyl) pyropheophorbide‐a for early‐stage cancer of the larynx: Phase Ib study

et al. 2015

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BackgroundThe purpose of this study was for us to report results regarding the safety of 3‐(1′‐hexyloxyethyl) pyropheophorbide‐a (HPPH) mediated photodynamic therapy (PDT) in early laryngeal disease, and offer preliminary information on treatment responses.MethodsA single‐institution, phase Ib, open label, noncomparative study of HPPH‐PDT in patients with high‐risk dysplasia, carcinoma in situ, and T1 squamous cell carcinoma (SCC) of the larynx. The primary outcomes were safety and maximum tolerated dose (MTD), and the secondary outcome was response.ResultsTwenty‐nine patients and 30 lesions were treated. The most common adverse event (AE) was transient hoarseness of voice. Severe edema, requiring tracheostomy, was the most serious AE, which occurred in 2 patients within several hours of therapy. The MTD was 100 J/cm2. Patients with T1 SCC seemed to have good complete response rate (82%) to HPPH‐PDT at MTD.ConclusionHPPH‐PDT can be safely used to treat early‐stage laryngeal cancer, with potential efficacy. © 2015 The Authors Head & Neck Published by Wiley Periodicals, Inc. Head Neck 38: E377–E383, 2016

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Photodynamic therapy with 3‐(1′‐hexyloxyethyl) pyropheophorbide‐a for early‐stage cancer of the larynx: Phase Ib study

et al. 2015

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“…The cytotoxic effect of PDT is instead induced by the formation of excessive ROS. PDT is believed to be able to preserve the laryngeal structures and restore voice quality after treating early‐stage carcinoma . The mechanism of reduced vocal fold scarring after PDT is still unclear, and there is no available study concerning the antifibrotic effect of PDT on vocal wound healing.…”

Section: Discussionmentioning

confidence: 99%

“…Shafirstein et al reported that there was no damage to the mucosal wave of vocal folds after PDT in some patients with laryngeal carcinoma . Silbergleit et al reported that PDT yielded significant improvement in amplitude of vibration, mucosal wave, and nonvibrating portion of the vocal folds after treatment of laryngeal malignancies . Recent dermatological studies have also indicated improved cosmetic and structural outcomes when treating skin wounds and scars using PDT …”

Section: Introductionmentioning

confidence: 99%

Photodynamic therapy induces antifibrotic alterations in primary human vocal fold fibroblasts

et al. 2018

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“…PDT has been used to treat laryngeal papillomas, premalignant lesions, and malignancies since the 1980s . It is also believed to be able to protect laryngeal function due to its ability to preserve the collagen matrix and induce antifibrotic effects . However, most studies used systemic administration of photosensitizers to treat laryngeal lesions.…”

Section: Introductionmentioning

confidence: 99%

Topical Application of 5‐Aminolevulinic Acid Is Sufficient for Photodynamic Therapy on Vocal Folds

et al. 2018

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Objectives To evaluate the feasibility of topical photodynamic therapy (PDT) using 5‐aminolevulinic acid (5‐ALA) for vocal fold leukoplakia. Study Design Ex vivo and in vivo. Methods 5‐ALA was applied topically as a 20% solution to ex vivo canine vocal folds. The penetration depth and concentrations of 5‐ALA in tissue were quantified using frozen sectioning and fluorescamine derivatization after 5‐ALA contact incubation or topical spraying. Then, 5‐ALA solution was sprayed on leporine vocal folds once, twice, or given systemically in vivo. Protoporphyrin IX (PPIX) location was visualized using fluorescence microscopy, and PPIX concentrations were measured using a fluorescent quantitative method. Hematoxylin and eosin (H&E) staining was performed to visualize the histological changes of vocal folds after PDT for each group. Results Topical incubation of 15 minutes with 5‐ALA achieved a penetration depth of over 2 mm and similar concentrations within the superficial 500 μm of epithelium, compared with longer incubation times. Topical spraying of 5‐ALA produced sufficient concentrations in vocal folds, but the retention time is short. An in vivo leporine model showed that laryngeal spraying of 20% 5‐ALA induced similar penetration depth and concentrations of PPIX compared to systemic administration of 5‐ALA. Two sprays of 20% 5‐ALA solution with an interval of 30 minutes are needed to produce complete exfoliation of vocal fold epithelium. Conclusion Topical PDT with laryngeal spraying of 20% 5‐ALA solution achieves sufficient therapeutic effects and is potentially applicable for the treatment of vocal fold leukoplakia. Level of Evidence NA Laryngoscope, 129:E80–E86, 2019

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Vocal Fold Vibration After Photofrin-Mediated Photodynamic Therapy for Treatment of Early-Stage Laryngeal Malignancies

Cited by 10 publications

References 16 publications

Photodynamic therapy with 3‐(1′‐hexyloxyethyl) pyropheophorbide‐a for early‐stage cancer of the larynx: Phase Ib study

Photodynamic therapy with 3‐(1′‐hexyloxyethyl) pyropheophorbide‐a for early‐stage cancer of the larynx: Phase Ib study

Photodynamic therapy induces antifibrotic alterations in primary human vocal fold fibroblasts

Topical Application of 5‐Aminolevulinic Acid Is Sufficient for Photodynamic Therapy on Vocal Folds

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