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Outcome of primary treatment of early laryngeal malignancies using photodynamic therapy
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Dept Otolaryngol & Head & Neck Surg.
Örebro Univ Hosp, Dept Oncol, Örebro, Sweden.
Örebro Univ Hosp, Dept Otolaryngol & Head & Neck Surg, Örebro, Sweden.
Örebro Univ Hosp, Dept Logoped & Phoniatr, Örebro, Sweden.
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2014 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, no 8, 852-858 p.Article in journal (Refereed) Published
Abstract [en]

Conclusion: Photodynamic therapy (PDT) is a viable and safe option for early laryngeal cancer that would be less suitably treated with radiation or trans-oral laser surgery (TLS). The cure rates with PDT appear to be comparable to those of conventional therapy, and the voice outcomes are also comparable. In the case of many sarcomas, PDT appears to be an organ- and function-sparing therapy, although it is more costly than other treatments.

Objectives: The aim of this study was to show the results of PDT when it is used as a primary treatment of early laryngeal cancer. Methods: We studied the results of PDT when used as a primary treatment. We looked at survival, effect on tumor, side effects, voice, and costs.

Results: The follow-up period was a median of 59 months. Nine of 10 patients were cured of their laryngeal cancer. PDT alone cured seven patients. All four of the sarcomas were cured using temoporfin. Two of three tumors that involved the anterior commissure were cured using only interstitial illumination with PDT. No serious side effects were noted. The patient's voices were improved after treatment in 5 of 10 cases, and none had a worsened voice.

Place, publisher, year, edition, pages
2014. Vol. 134, no 8, 852-858 p.
Keyword [en]
Cancer, larynx, PDT, sarcoma, squamous cell carcinoma, porfimer sodium, temoporfin, voice
National Category
Otorhinolaryngology
Research subject
Oto-Rhino-Laryngology
Identifiers
URN: urn:nbn:se:oru:diva-36374DOI: 10.3109/00016489.2014.906748ISI: 000340137200013PubMedID: 24856450Scopus ID: 2-s2.0-84904327200OAI: oai:DiVA.org:oru-36374DiVA: diva2:743137
Available from: 2014-09-03 Created: 2014-09-03 Last updated: 2017-10-18Bibliographically approved
In thesis
1. Photodynamic therapy in the head and neck
Open this publication in new window or tab >>Photodynamic therapy in the head and neck
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Fotokemisk behandling av tumörer inom huvud- och halsområdet
Abstract [en]

Photodynamic therapy, PDT, is a method to diagnose and treat cancer. In PDT a sensitizer is administered to the patient and this sensitizer is accumulated in tumors. If the sensitizer-containing tumor is subjected to a laser of a specific wavelength the tumor is fluorescing allowing diagnostics. If other wavelengths are used a process involving reactive oxygen species and singlet oxygen is started and the tumor cells are killed. This process thus requires oxygen as well.

This thesis investigates how UV-induced damage of the skin and different physiological factors of the skin influences the uptake of 5- aminolevulinic acid, ALA, and its conversion to the active sensitizer protoporphyrin IX, PpIX. It shows that UV-induced damage affects both the uptake and production of PpIX. UV-induced damage lowers the PpIX produced after ALA application both if the damage is acute and in chronically UV-affected skin.

The PpIX production differs inter and intra individually. When looking how different physiological factors affect the PpIX production after topically applied ALA the thesis shows that an increase of temperature increases the production. No correlation between the formation of PpIX and the density of hair follicles was found and a weak correlation was seen comparing the epidermal and total dermal thickness and PpIX production

The thesis also shows how PDT is used in treating laryngeal malignancies. It shows that it is possible to cure laryngeal tumors (both squamous cell carcinomas and sarcomas) using PDT primarily, and that the cure rate as well as outcome of voice and patient safety is comparable to the conventional treatment modalities.

PDT can also be used as a function and organ sparing treatment for recurring laryngeal cancers, both squamous cell carcinomas and sarcomas.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2014. 74 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 110
Keyword
Photo Dynamic Therapy, Cancer, Skin, Larynx, 5-ALA, UVradiation, sarcoma, squamous cell carcinoma, porfimer sodium, temoporfin, voice
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-35953 (URN)978-91-7529-039-3 (ISBN)
Public defence
2014-09-19, Universitetssjukhuset, B-hus aulan, Södra Grev Rosengatan, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2014-08-14 Created: 2014-08-14 Last updated: 2017-10-17Bibliographically approved

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von Beckerath, Mathias P.Landström, Fredrik J.Löfgren, Axel LennartMöller, Claes
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School of Health and Medical Sciences, Örebro University, SwedenÖrebro University HospitalDepartment of Clinical Medicine
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