Adjuvant intraoperative photodynamic therapy in head and neck cancer.
Adjuvant intraoperative photodynamic therapy in head and neck cancer.
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DOI：
10.1001/jamaoto.2013.3387
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发表时间：
2013-07
影响因子：
7.8
通讯作者：
Henderson, Barbara
中科院分区：
文献类型：
--
作者：
Rigual, Nestor R.;Shafirstein, Gal;Frustino, Jennifer;Seshadri, Mukund;Cooper, Michele;Wilding, Gregory;Sullivan, Maureen A.;Henderson, Barbara
目前迫切需要制定局部术中辅助治疗策略，以改善接受头颈部手术的癌症患者的预后。目的探讨光动力疗法联合手术治疗头颈部鳞状细胞癌的安全性。一项在综合性癌症中心进行的非随机、单臂、单中心、I期研究，纳入16例经活检证实的原发性或复发性可切除头颈部鳞状细胞癌成人患者（中位年龄65岁）。静脉注射HPPH（4.0 mg/m2），然后在肿瘤切除后立即在手术床上用665 nm激光激活。不良事件和最高激光剂量。15例患者接受了整个疗程，1例患者因无关心肌梗死接受了HPPH，术中未使用激光。病变部位包括喉（7例患者）、口腔（6例患者）、皮肤（1例患者）、耳道（1例患者）和口咽（1例患者，仅接受HPPH）。与光动力疗法相关的最常见不良事件为轻度至中度水肿（9例患者）和疼痛（3例患者）。1例患者在挽救性喉切除术后发生3级瘘，另1例患者发生3级伤口感染和下颌骨骨折。光毒性反应包括1例中度畏光和2例轻度至中度皮肤灼伤（2例因手术室聚光灯所致，1例因脉搏血氧仪所致）。最高激光剂量为75 J/cm 2。HPPH-光动力疗法与手术联合应用治疗头颈部鳞癌安全性高，值得进一步研究。
There is an immediate need to develop local intraoperative adjuvant treatment strategies to improve outcomes in patients with cancer who undergo head and neck surgery. To determine the safety of photodynamic therapy with 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a (HPPH) in combination with surgery in patients with head and neck squamous cell carcinoma. Nonrandomized, single-arm, single-site, phase 1 study at a comprehensive cancer center among 16 adult patients (median age, 65 years) with biopsy-proved primary or recurrent resectable head and neck squamous cell carcinoma. Intravenous injection of HPPH (4.0 mg/m2), followed by activation with 665-nm laser light in the surgical bed immediately after tumor resection. Adverse events and highest laser light dose. Fifteen patients received the full course of treatment, and 1 patient received HPPH without intraoperative laser light because of an unrelated myocardial infarction. Disease sites included larynx (7 patients), oral cavity (6 patients), skin (1 patient), ear canal (1 patient), and oropharynx (1 patient, who received HPPH only). The most frequent adverse events related to photodynamic therapy were mild to moderate edema (9 patients) and pain (3 patients). One patient developed a grade 3 fistula after salvage laryngectomy, and another patient developed a grade 3 wound infection and mandibular fracture. Phototoxicity reactions included 1 moderate photophobia and 2 mild to moderate skin burns (2 due to operating room spotlights and 1 due to the pulse oximeter). The highest laser light dose was 75 J/cm2. The adjuvant use of HPPH-photodynamic therapy and surgery for head and neck squamous cell carcinoma seems safe and deserves further study.
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影响因子：
2.4
作者：
Nava, Hector R.;Allamaneni, Shyam S.;Dougherty, Thomas J.;Cooper, Michele T.;Tan, Wei;Wilding, Gregory;Henderson, Barbara W.
通讯作者：
Henderson, Barbara W.
影响因子：
3.4
作者：
Gauthier, Pierre;Audet, Nathalie;Rochette, Linda
通讯作者：
Rochette, Linda
影响因子：
6.2
作者：
Zafereo, Mark E.;Hanasono, Matthew M.;Weber, Randal S.
通讯作者：
Weber, Randal S.
影响因子：
2.4
作者：
Lobel, J;MacDonald, IJ;Dougherty, TJ
通讯作者：
Dougherty, TJ
影响因子：
2.6
作者：
Nathan, CAO;Amirghahri, N;Stucker, FJ
通讯作者：
Stucker, FJ