Photodynamic Therapy for 101 Early Cancers of the Upper Aerodigestive Tract, the Esophagus, and the Bronchi: A Single-Institution Experience
- Radu, A. Department of Otolaryngology, Head and Neck Surgery, CHUV Hospital, Lausanne CH-1011, Switzerland
- Grosjean, P. Department of Otolaryngology, Head and Neck Surgery, CHUV Hospital, Lausanne CH-1011, Switzerland
- Fontolliet, Ch. lnstitute of Pathology, CHUV Hospital, Lausanne CH-1011, Switzerland
- Wagnieres, G. lnstitute of Environmental Engineering, EPFL, Lausanne CH-1015, Switzerland
- Woodtli, A. lnstitute of Environmental Engineering, EPFL, Lausanne CH-1015, Switzerland
- Bergh, H. Van Den lnstitute of Environmental Engineering, EPFL, Lausanne CH-1015, Switzerland
- Monnier, Ph. Department of Otolaryngology, Head and Neck Surgery, CHUV Hospital, Lausanne CH-1011, Switzerland
Published in:
- Diagnostic and Therapeutic Endoscopy. - Hindawi Limited. - 1999, vol. 5, no. 3, p. 145-154
English
Cancer, when detected at an early stage, has a very good probability of being eradicated by
surgery or radiotherapy. However, less aggressive treatments also tend to provide high rates
of cure without the side effects of radical therapy. We report on the results of our clinical
experience with photodynamic therapy (PDT) for the treatment of early carcinomas in the
upper aerodigestive tract, the esophagus, and the tracheobronchial tree. Sixty-four patients
with 101 squamous cell carcinomas were treated with three different photosensitizers:
hematoporphyrin derivative (HPD), Photofrin II, and tetra (m-hydroxyphenyl)chlorin
(mTHPC). Seventy-seven (76%) tumors showed a complete rsponse with no recurrence
after a mean follow-up period of 27 months. There was no significant difference in terms of
cure rates among the three dyes. However, mTHPC has a stronger phototoxicity and induces
a shorter skin photosensitization than either of the other photosensitizers. There were eight
major complications: three esophagotracheal fistulae after illumination with red light in the
esophagus, two esophageal stenoses following 360° circumferential irradiation, and three
bronchial stenoses. Illumination with the less penetrating green light and the use of a 180° or
240° windowed cylindrical light distributor render the risk of complications in the esophagus
essentially impossible, without reducing the efficacy of the treatment. Therefore, PDT may be
considered as a safe and effective treatment for early carcinomas of the upper aerodigestive
tract, the esophagus, and the tracheobronchial tree.
surgery or radiotherapy. However, less aggressive treatments also tend to provide high rates
of cure without the side effects of radical therapy. We report on the results of our clinical
experience with photodynamic therapy (PDT) for the treatment of early carcinomas in the
upper aerodigestive tract, the esophagus, and the tracheobronchial tree. Sixty-four patients
with 101 squamous cell carcinomas were treated with three different photosensitizers:
hematoporphyrin derivative (HPD), Photofrin II, and tetra (m-hydroxyphenyl)chlorin
(mTHPC). Seventy-seven (76%) tumors showed a complete rsponse with no recurrence
after a mean follow-up period of 27 months. There was no significant difference in terms of
cure rates among the three dyes. However, mTHPC has a stronger phototoxicity and induces
a shorter skin photosensitization than either of the other photosensitizers. There were eight
major complications: three esophagotracheal fistulae after illumination with red light in the
esophagus, two esophageal stenoses following 360° circumferential irradiation, and three
bronchial stenoses. Illumination with the less penetrating green light and the use of a 180° or
240° windowed cylindrical light distributor render the risk of complications in the esophagus
essentially impossible, without reducing the efficacy of the treatment. Therefore, PDT may be
considered as a safe and effective treatment for early carcinomas of the upper aerodigestive
tract, the esophagus, and the tracheobronchial tree.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1155/dte.5.145
- ISSN 1070-3608
- Persistent URL
- https://sonar.ch/global/documents/46371
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