mTHPC-mediated photodynamic therapy for early oral squamous cell carcinoma
mTHPC-mediated photodynamic therapy for early oral squamous cell carcinoma
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DOI：
10.1002/ijc.20209
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发表时间：
2004-08-10
影响因子：
6.4
通讯作者：
Putnam, G
中科院分区：
文献类型：
--
作者：
Hopper, C;Kübler, A;Putnam, G
手术和放疗是早期口腔鳞状细胞癌的标准治疗方法，两者都能得到良好的肿瘤控制。然而，这两种治疗方式都会造成功能或美观损伤，并且有些患者两者都是禁忌的。此外，口腔中存在异时肿瘤发生的显着风险，并且通过手术或放疗进行挽救或再治疗会造成困难。光动力疗法 (PDT) 具有改善功能和美容效果的潜力，同时实现可比的肿瘤控制。我们进行了一项开放标签、多中心研究，以评估间四羟苯基二氯林 (mTHPC) 对早期口腔癌患者的疗效和安全性。 121 名患者接受静脉注射 mTHPC，96 小时后用 652 nm 激光照射肿瘤表面。在这些患者中，114 名符合方案。 85% 符合方案的患者（114 名患者中的 97 名）实现了肿瘤完全缓解。 85% 的应答者在第 1 年保持完全应答，77% 在第 2 年保持完全应答。一年和两年精算生存率分别为 89% 和 75%。研究人员认为，肿瘤清除伴随着优异的美容和功能结果，且不影响患者的体能状态。 82% 的患者报告治疗部位有轻度至中度疼痛，这是 PDT 在口腔中公认的副作用，但通过适当的镇痛可以控制。据报道，13% 的患者出现轻度至中度皮肤光敏反应。 mTHPC 为早期口腔鳞状细胞癌提供了一种有效的替代治疗方法。它具有出色的功能和美容效果，并且可以与其他标准疗法结合使用。 (C) 2004 Wiley-Liss, Inc.
Surgery and radiotherapy are standard treatments for early oral squamous cell carcinoma, both resulting in good tumour control. However, neither of these modalities is without consequent functional or cosmetic impairment, and there are patients in whom both are contraindicated. Furthermore, there is a significant risk of metachronous tumours developing in the oral cavity, and salvage or retreatment with either surgery or radiotherapy poses difficulties. Photodynamic therapy (PDT) offers the potential for improved functional and cosmetic outcomes, while achieving comparable tumour control. We conducted an open-label, multicentre study to assess the efficacy and safety of metatetrahydroxyphenylchlorin (mTHPC) in patients with early oral cancer. One hundred twenty-one patients received intravenously administered mTHPC, followed 96 hr later by illumination of the tumour surface with 652 nm laser light. Of these patients, 114 were protocol compliant. A complete tumour response was achieved in 85% of protocol-compliant patients (97 of 114 patients). A complete response was maintained in 85% of responders at I year and in 77% at 2 years. One- and 2-year actuarial survival rates were 89% and 75%, respectively. In the opinion of the investigators, tumour clearance was accompanied by excellent cosmetic and functional results, without impact on the patients' performance status. Mild-to-moderate pain at the treatment site, a recognised side effect of PDT in the oral cavity, was reported by 82% of patients but was manageable with appropriate analgesia. Mild-to-moderate skin photosensitivity reactions were reported for 13% of patients. mTHPC offers an effective alternative treatment for early oral squamous cell carcinoma. It is associated with excellent functional and cosmetic results and can be used in conjunction with other standard therapies. (C) 2004 Wiley-Liss, Inc.