mTHPC-mediated photodynamic therapy in patients with advanced, incurable head and neck cancer: A multicenter study of 128 patients
mTHPC-mediated photodynamic therapy in patients with advanced, incurable head and neck cancer: A multicenter study of 128 patients
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DOI：
10.1002/hed.10372
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发表时间：
2004-03-01
影响因子：
2.9
通讯作者：
Biel, MA
中科院分区：
文献类型：
--
作者：
D'Cruz, AK;Robinson, MH;Biel, MA
背景。这项多中心研究的目的是评估头颈部复发/难治性鳞状细胞癌治疗失败或不适合常规治疗方式的患者在接受mTHPC治疗后的肿瘤反应、临床生活质量、生存和安全性。128例患者接受mTHPC治疗，96小时后用652 nm激光照射肿瘤表面。根据世卫组织标准和肿瘤质量从基线开始减少来评估肿瘤反应。临床生活质量效益是基于华盛顿大学生活质量问卷调查的结果。根据世卫组织的标准，38%的可评估患者实现了总体肿瘤缓解，16%实现了完全肿瘤缓解。43%的可评估病变达到100%的肿瘤体积缩小，58%达到50%或更大的肿瘤体积缩小。53%的可评估患者经历了显著的临床生活质量改善。亚群分析显示，在肿瘤深度小于10mm的患者和病变完全照亮的患者中，有两个亚组的反应明显更好。在满足两种类型的患者中，总体肿瘤缓解率为54%，完全肿瘤缓解率为30%，61%的患者表现出显著的临床生活质量改善。应答者的中位生存期明显更好。未检测到重大毒性反应。已用尽其他治疗方案的晚期头颈部癌症患者可以通过mTHPC获得显著的临床效益和生活质量的改善。(C) 2004 Wiley期刊有限公司
Background. The aim of this multicenter study was to assess tumor response, clinical quality-of-life benefit, survival, and safety after treatment with mTHPC in patients with recurrent/refractory squamous cell carcinoma of the head and neck unsuccessfully treated or unsuitable for treatment with conventional modalities.Methods. One hundred twenty-eight patients were treated with mTHPC followed, 96 hours later, by illumination of the tumor surface with 652-nm laser light. Tumor response was assessed with WHO criteria and tumor mass reduction from baseline. Clinical quality-of-life benefit was based on the University of Washington Quality-of-Life questionnaire.Results. By use of WHO criteria, 38% of evaluable patients achieved an overall tumor response, and 16% achieved a complete tumor response. Forty-three percent of assessable lesions achieved 100% tumor mass reduction, and 58% achieved 50% or greater tumor mass reduction. Fifty-three percent of evaluable patients experienced significant clinical quality-of-life benefit. Subset analyses revealed two subgroups in which significantly better responses were seen in patients with tumors 10 mm or less in depth and patients with fully illuminated lesions. In patients fulfilling both categories, overall tumor response was 54%, complete tumor response was 30%, and 61% demonstrated significant clinical quality-of-life benefit. Median survival was significantly better in responders. No major toxicities were detected.Conclusions. Patients with advanced cancer of the head and neck who have exhausted other treatment options can achieve significant clinical benefit and improvement in quality of life with mTHPC. (C) 2004 Wiley Periodicals, Inc.