mTHPC-mediated Photodynamic Therapy of Early Stage Oral Squamous Cell Carcinoma: A Comparison to Surgical Treatment
mTHPC-mediated Photodynamic Therapy of Early Stage Oral Squamous Cell Carcinoma: A Comparison to Surgical Treatment
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DOI：
10.1245/s10434-013-3006-6
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发表时间：
2013-09-01
影响因子：
3.7
通讯作者：
Witjes, Max J. H.
中科院分区：
文献类型：
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作者：
de Visscher, Sebastiaan A. H. J.;Melchers, Lieuwe J.;Witjes, Max J. H.
mTHPC介导的光动力疗法（PDT）用于治疗早期头颈部鳞状细胞癌。本研究是一项回顾性比较PDT与经口手术治疗口腔/口咽部早期原发性鳞状细胞癌的研究，PDT数据来自四个研究数据库，手术结果来自我们的机构数据库。为了选择相似的原发性肿瘤，手术组的浸润深度限制为5 mm。PDT组中共有126例T1和30例T2肿瘤，手术治疗组中有58例T1和33例T2肿瘤，PDT和手术的完全缓解率分别为86%和76%，T2分别为63%和78%。与手术相比，PDT的局部无病生存率较低。然而，当比较局部再治疗的需要时，T1肿瘤没有发现显著差异，而T2肿瘤手术导致局部再治疗的需要显著减少。PDT治疗T1期肿瘤与手术治疗相比，需要再次治疗的比例相似，而PDT治疗T2期肿瘤的效果更差。手术的局部无病生存率优于PDT。这可能受到手术具有可用组织学的益处的影响。这就允许及早决定是否进行再干预，而对于PDT，则必须采取观望政策。未来的前瞻性研究应比较疗效和发病率。
mTHPC-mediated photodynamic therapy (PDT) is used for treatment of early head and neck squamous cell carcinoma. This study is a retrospective comparison of PDT with transoral surgery in the treatment of early primary squamous cell carcinoma of the oral cavity/oropharynx.PDT data were retrieved from four study databases; surgical results were retrieved from our institutional database. To select similar primary tumors, infiltration depth was restricted to 5 mm for the surgery group. A total of 126 T1 and 30 T2 tumors were included in the PDT group, and 58 T1 and 33 T2 tumors were included in the surgically treated group.Complete response rates with PDT and surgery were 86 and 76 % for T1, respectively, and for T2 63 and 78 %. Lower local disease-free survival for PDT compared to surgery was found. However, when comparing the need for local retreatment, no significant difference for T1 tumors was found, while for T2 tumors surgery resulted in significantly less need for local retreatment. No significant differences in overall survival between surgery and PDT were observed.PDT for T1 tumors results in a similar need for retreatment compared to surgery, while for T2 tumors PDT performs worse. Local disease-free survival for surgery is better than for PDT. This may be influenced by the benefit surgery has of having histology available. This allows an early decision on reintervention, while for PDT one has to follow a wait-and-see policy. Future prospective studies should compare efficacy as well as morbidity.