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Cardoso M, Marto CM, Paula A, Coelho AS, Amaro I, Pineiro M, Pinho E Melo TMVD, Marques Ferreira M, Botelho MF, Carrilho E, Laranjo M. Effectiveness of photodynamic therapy on treatment response and survival in patients with recurrent oral squamous cell carcinoma: A systematic review. Photodiagnosis Photodyn Ther 2024; 48:104242. [PMID: 38857775 DOI: 10.1016/j.pdpdt.2024.104242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 05/06/2024] [Accepted: 06/07/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND This systematic review assessed the effectiveness of photodynamic therapy (PDT) in patients with recurrent oral squamous cell carcinoma (OSCC). METHODS Clinical studies on recurrent OSCC treated with PDT alone were included. Combined treatment strategies were excluded. The search was performed on Medline/Pubmed, Cochrane Library, Embase, Web of Science and ClinicalTrials.gov, manual search, and grey literature. RESULTS The eleven included studies were observational. The risk of bias and methodological quality were evaluated using the Newcastle-Ottawa Quality Assessment Scale. The studies reported the use of hematoporphyrin derivative, PhotofrinⓇ, FoscanⓇ and 5-aminolevulinic acid. Data on treatment response and survival was collected. Secondarily, postoperative courses and patient's quality of life/acceptance were reported whenever available. PhotofrinⓇ and FoscanⓇ were the most used photosensitisers, with more complete responses. Lesions responding less favourably were on posterior regions or deep-seated in the tissue. CONCLUSIONS Although treatment response differs between treatment protocols, PDT stands as a viable treatment option to be considered, as it can achieve therapeutic results and disease-free, long-lasting periods. Partial treatment responses may be of interest when achieving eligibility for other treatment strategies. Despite this study's limitations, which considered four photosensitisers, PhotofrinⓇ was the most used but more recent photosensitisers like FoscanⓇ have greater chemical stability, tissue penetration, and may be more efficacious on recurrent OSCC.
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Affiliation(s)
- Miguel Cardoso
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Institute of Biophysics, Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Coimbra Chemistry Centre - Institute of Molecular Sciences and Department of Chemistry, Rua Larga, Coimbra, 3004-535, Portugal.
| | - Carlos Miguel Marto
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Institute of Biophysics, Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Institute of Experimental Pathology, Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Institute of Integrated Clinical Practice and Laboratory for Evidence-based Science and Precision Dentistry, Faculty of Medicine, Av. Bissaya Barreto, Bloco de Celas, 3000-075 Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Rua Larga, Coimbra, 3004-504, Portugal; Clinical Academic Center of Coimbra (CACC), Praceta Professor Mota Pinto, Coimbra, 3004-561, Portugal; Univ Coimbra, CEMMPRE, ARISE, Pinhal de Marrocos, 3030-788 Coimbra, Portugal
| | - Anabela Paula
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Institute of Integrated Clinical Practice and Laboratory for Evidence-based Science and Precision Dentistry, Faculty of Medicine, Av. Bissaya Barreto, Bloco de Celas, 3000-075 Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Rua Larga, Coimbra, 3004-504, Portugal; Clinical Academic Center of Coimbra (CACC), Praceta Professor Mota Pinto, Coimbra, 3004-561, Portugal; Univ Coimbra, CEMMPRE, ARISE, Pinhal de Marrocos, 3030-788 Coimbra, Portugal
| | - Ana Sofia Coelho
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Institute of Integrated Clinical Practice and Laboratory for Evidence-based Science and Precision Dentistry, Faculty of Medicine, Av. Bissaya Barreto, Bloco de Celas, 3000-075 Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Rua Larga, Coimbra, 3004-504, Portugal; Clinical Academic Center of Coimbra (CACC), Praceta Professor Mota Pinto, Coimbra, 3004-561, Portugal; Univ Coimbra, CEMMPRE, ARISE, Pinhal de Marrocos, 3030-788 Coimbra, Portugal
| | - Inês Amaro
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Institute of Integrated Clinical Practice and Laboratory for Evidence-based Science and Precision Dentistry, Faculty of Medicine, Av. Bissaya Barreto, Bloco de Celas, 3000-075 Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Rua Larga, Coimbra, 3004-504, Portugal; Clinical Academic Center of Coimbra (CACC), Praceta Professor Mota Pinto, Coimbra, 3004-561, Portugal; Univ Coimbra, CEMMPRE, ARISE, Pinhal de Marrocos, 3030-788 Coimbra, Portugal
| | - Marta Pineiro
- Univ Coimbra, Coimbra Chemistry Centre - Institute of Molecular Sciences and Department of Chemistry, Rua Larga, Coimbra, 3004-535, Portugal
| | - Teresa M V D Pinho E Melo
- Univ Coimbra, Coimbra Chemistry Centre - Institute of Molecular Sciences and Department of Chemistry, Rua Larga, Coimbra, 3004-535, Portugal
| | - Manuel Marques Ferreira
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Rua Larga, Coimbra, 3004-504, Portugal; Clinical Academic Center of Coimbra (CACC), Praceta Professor Mota Pinto, Coimbra, 3004-561, Portugal; Univ Coimbra, CEMMPRE, ARISE, Pinhal de Marrocos, 3030-788 Coimbra, Portugal; Univ Coimbra, Institute of Endodontics, Faculty of Medicine, Av. Bissaya Barreto, Bloco de Celas, 3000-075 Coimbra, Portugal
| | - Maria Filomena Botelho
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Institute of Biophysics, Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Rua Larga, Coimbra, 3004-504, Portugal; Clinical Academic Center of Coimbra (CACC), Praceta Professor Mota Pinto, Coimbra, 3004-561, Portugal
| | - Eunice Carrilho
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Institute of Integrated Clinical Practice and Laboratory for Evidence-based Science and Precision Dentistry, Faculty of Medicine, Av. Bissaya Barreto, Bloco de Celas, 3000-075 Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Rua Larga, Coimbra, 3004-504, Portugal; Clinical Academic Center of Coimbra (CACC), Praceta Professor Mota Pinto, Coimbra, 3004-561, Portugal; Univ Coimbra, CEMMPRE, ARISE, Pinhal de Marrocos, 3030-788 Coimbra, Portugal
| | - Mafalda Laranjo
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Institute of Biophysics, Faculty of Medicine, Azinhaga de Santa Comba, Pólo III - Pólo das Ciências da Saúde, Coimbra, 3000-548, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Rua Larga, Coimbra, 3004-504, Portugal; Clinical Academic Center of Coimbra (CACC), Praceta Professor Mota Pinto, Coimbra, 3004-561, Portugal.
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Zhang C, Hou Q, Ren H, Li G. Successful Treatment of Laryngeal leukoplakia by photodynamic Therapy with Local Application of 5-Aminolevulinic Acid and 635nm Laser: A Case Report. Photodiagnosis Photodyn Ther 2022; 39:102999. [DOI: 10.1016/j.pdpdt.2022.102999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 11/24/2022]
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Photodynamic therapy for squamous cell carcinoma of the head and neck: narrative review focusing on photosensitizers. Lasers Med Sci 2021; 37:1441-1470. [PMID: 34855034 DOI: 10.1007/s10103-021-03462-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022]
Abstract
This narrative review aimed to evaluate the effectiveness of PDT in early or advanced squamous cell carcinoma of the head and neck (SCCHN). Scopus, MEDLINE/PubMed, and Embase were searched electronically following the PRISMA protocol. Quality assessment was performed according to JBI, NIH, and AMSTAR protocols. The main outcomes evaluated were treatment response, recurrence, survival, and adverse effects. A total of 49 articles met the search criteria: 43 case series, two cohort studies, two prospective before-after clinical trials, one systematic review, and one meta-analysis. Data from 2121 SCCHN patients were included. The response to PDT was variable according to the type of photosensitizer, tumor location, and tumor stage. In general, higher complete responses rated were observed in T1/T2 SCCHN, mainly with mTHPC-mediated PDT. With regard to T3/T4 or advanced SCCHN tumors, there is no compelling evidence suggesting the effectiveness of PDT. Any adverse effects reported were well tolerated by patients. The present review suggests that PDT is a promising treatment modality for early-stage SCCHN. Although there are limitations due to the low level of evidence of the included studies, we believe that the present review could help to design robust clinical trials to determine the efficacy of PDT in SCCHN.
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Pucci C, Martinelli C, Degl'Innocenti A, Desii A, De Pasquale D, Ciofani G. Light-Activated Biomedical Applications of Chlorophyll Derivatives. Macromol Biosci 2021; 21:e2100181. [PMID: 34212510 DOI: 10.1002/mabi.202100181] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/06/2021] [Indexed: 02/01/2023]
Abstract
Tetrapyrroles are the basis of essential physiological functions in most living organisms. These compounds represent the basic scaffold of porphyrins, chlorophylls, and bacteriochlorophylls, among others. Chlorophyll derivatives, obtained by the natural or artificial degradation of chlorophylls, present unique properties, holding great potential in the scientific and medical fields. Indeed, they can act as cancer-preventing agents, antimutagens, apoptosis inducers, efficient antioxidants, as well as antimicrobial and immunomodulatory molecules. Moreover, thanks to their peculiar optical properties, they can be exploited as photosensitizers for photodynamic therapy and as vision enhancers. Most of these molecules, however, are highly hydrophobic and poorly soluble in biological fluids, and may display undesired toxicity due to accumulation in healthy tissues. The advent of nanomedicine has prompted the development of nanoparticles acting as carriers for chlorophyll derivatives, facilitating their targeted administration with demonstrated applicability in diagnosis and therapy. In this review, the chemical and physical properties of chlorophyll derivatives that justify their usage in the biomedical field, with particular regard to light-activated dynamics are described. Their role as antioxidants and photoactive agents are discussed, introducing the most recent nanomedical applications and focusing on inorganic and organic nanocarriers exploited in vitro and in vivo.
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Affiliation(s)
- Carlotta Pucci
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, Pontedera, Pisa, 56025, Italy
| | - Chiara Martinelli
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza Leonardo da Vinci 32, Milan, 20133, Italy
| | - Andrea Degl'Innocenti
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, Pontedera, Pisa, 56025, Italy
| | - Andrea Desii
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, Pontedera, Pisa, 56025, Italy
| | - Daniele De Pasquale
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, Pontedera, Pisa, 56025, Italy
| | - Gianni Ciofani
- Istituto Italiano di Tecnologia, Smart Bio-Interfaces, Viale Rinaldo Piaggio 34, Pontedera, Pisa, 56025, Italy
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Yang K, Luo M, Li H, Abdulrehman G, Kang L. Effects of jasplakinolide on cytotoxicity, cytoskeleton and apoptosis in two different colon cancer cell lines treated with m-THPC-PDT. Photodiagnosis Photodyn Ther 2021; 35:102425. [PMID: 34214686 DOI: 10.1016/j.pdpdt.2021.102425] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/25/2021] [Accepted: 06/25/2021] [Indexed: 12/28/2022]
Abstract
Colorectal cancer (CRC) is a common malignant tumor, and metastasis is one of the most important challenges in the treatment of CRC. Photodynamic therapy (PDT) is a novel and non-invasive treatment that influence cytoskeleton and to reduce cancer metastases. In addition, cytoskeleton is related to cancer metastases. Two isogenic colorectal cancer cell lines SW480 and SW620 were used in the present study, we found that m-THPC mediated PDT changed the cytotoxicity, apoptosis and cytoskeleton in both cell lines. Interestingly, the expression of intermediate filaments protein cytokeratin18 were different in the two cell lines. In order to further confirm the relationship between cytoskeleton and cell migration, we combined with microfilament stabilizer jasplakinolide (JASP) to observe the effects of microfilaments on cell migration, cytotoxicity and apoptosis. Taken together, these findings suggest that m-THPC-PDT could induce cytoplasmic cytoskeleton destruction in both types of cells, especially on microfilaments and microtubules. Moreover, in SW480 cells, microtubules may participate in the apoptosis process induced by m-THPC-PDT, while microfilaments may participate in the process of m-THPC-PDT inhibiting cell migration. But in SW620 cells, only microfilaments may be involved in m-THPC-PDT induced apoptosis and inhibition of cell migration.
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Affiliation(s)
- Kaizhen Yang
- Teaching & Research Department, The First People's Hospital of Urumqi, 1 Jiankang Road, Urumqi, Xinjiang Uygur Autonomous Region, China.
| | - Mengyu Luo
- School of Public Health, Xinjiang Medical University, 567 SHangde North Road, Urumqi, Xinjiang Uygur Autonomous Region, China.
| | - Hongxia Li
- School of Public Health, Xinjiang Medical University, 567 SHangde North Road, Urumqi, Xinjiang Uygur Autonomous Region, China.
| | - Gulinur Abdulrehman
- Cancer Hospital of The Third Affiliated Hospital of Xinjiang Medical University, 789 Suzhou East Road, Urumqi, Xinjiang Uygur Autonomous Region, China.
| | - Ling Kang
- School of Public Health, Xinjiang Medical University, 567 SHangde North Road, Urumqi, Xinjiang Uygur Autonomous Region, China.
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Photodynamic Therapy for Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF PHOTOENERGY 2021. [DOI: 10.1155/2021/6641358] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
To assess the efficacy of photodynamic therapy (PDT) for oral squamous cell carcinoma (OSCC), literature on this topic from Embase, PubMed, and Web of Science were obtained and analyzed. The response and recurrence rates with 95% confidence intervals (CI) were calculated using the DerSimonia–Laird method. The pooled complete response (CR) rate from the included studies was 0.799 (95% CI: 0.708–0.867), while the overall response (OR) rate was 0.967 (95% CI: 0.902–0.989). The recurrence rate (RR) was 0.158 (95% CI: 0.090–0.264). A subgroup analysis of lesion site, photosensitizer, laser type, radiant exposure, and power density revealed no statistically significant differences. In general, PDT is effective for the treatment of early OSCC. Investigations on the influence of PDT on the survival of OSCC patients, optimization of the treatment regimen, and evaluation of response after treatment are still needed.
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Cao D, Li H, Luo Y, Feng N, Ci T. Heparin modified photosensitizer-loaded liposomes for tumor treatment and alleviating metastasis in phototherapy. Int J Biol Macromol 2020; 168:526-536. [PMID: 33310104 DOI: 10.1016/j.ijbiomac.2020.12.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 12/14/2022]
Abstract
Phototherapy holds promise in cancer treatment for its prominent antitumor efficacy and low systematic toxicity compared with traditional chemotherapy. However, the higher risk of tumor metastasis caused by the severe hypoxic state during phototherapy is a threat in practical use. Here, in order to tackle this challenge, we developed a delivery system via loading the photosensitizer indocyanine green (ICG) into the low molecular weight heparin (LMWH) modified liposomes (LMWH-ICG-Lip) to realize the synergistic effects between photosensitizer and drug vehicle, achieving better phototherapeutic efficacy and meanwhile alleviating the potential risk of tumor metastasis caused by phototherapy. In this system, besides elongating the photosensitizers' circulation time and enhancing their accumulating efficacy to tumor tissues, LMWH itself also exhibited anti-metastasis efficacy via inhibiting adhesion of platelets to tumor cells and decreasing migration and invasion capability of tumor cells. In vivo efficacy evaluation was conducted on orthotopic 4T1 breast cancer model, and the system of LMWH-ICG-Lip could alleviate metastasis potential of residual tumor cells after irradiation, and elicit optimistic antitumor and anti-metastasis efficacy for phototherapy.
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Affiliation(s)
- Dinglingge Cao
- Department of Pharmaceutical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 200433, China
| | - Huangjuan Li
- Department of Pharmaceutical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Department of Pharmaceutics, China Pharmaceutical University, Nanjing, Jiangsu Province 210009, China
| | - Yuan Luo
- Department of Pharmaceutics, China Pharmaceutical University, Nanjing, Jiangsu Province 210009, China
| | - Nianping Feng
- Department of Pharmaceutical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
| | - Tianyuan Ci
- Department of Pharmaceutical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 200433, China; Department of Pharmaceutics, China Pharmaceutical University, Nanjing, Jiangsu Province 210009, China.
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Zhang Q, He J, Yu W, Li Y, Liu Z, Zhou B, Liu Y. A promising anticancer drug: a photosensitizer based on the porphyrin skeleton. RSC Med Chem 2020; 11:427-437. [PMID: 33479647 PMCID: PMC7460723 DOI: 10.1039/c9md00558g] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 01/28/2020] [Indexed: 12/12/2022] Open
Abstract
Photodynamic therapy (PDT) is a minimally invasive combination of treatments that treat tumors and other diseases by using photosensitizers, light and oxygen to produce cytotoxic reactive oxygen species (ROS) inducing tumor cell apoptosis. Photosensitizers are the key part of PDT for clinical application and experimental research, and most of them are porphyrin compounds at present. Due to their unique affinity for tumor tissues, porphyrins are not only excellent photosensitizers, but also good carriers to transport other active drugs into tumor tissues, which can exert synergistic anticancer effects of PDT and chemotherapy. This article reviews the clinical development of porphyrin photosensitizers and the research status of porphyrin containing bioactive groups. Finally, future perspectives and the current challenges of photosensitizers based on the porphyrin skeleton are discussed.
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Affiliation(s)
- Qizhi Zhang
- Institute of Pharmacy & Pharmacology , Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study , University of South China , Hengyang City , Hunan Province 421001 , P.R. China .
- Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research , 28 Western Changshen Road , Hengyang City , Hunan Province 421001 , P.R. China
| | - Jun He
- Institute of Chemistry & Chemical Engineering , University of South China , Hengyang City , Hunan Province 421001 , P.R. China
| | - Wenmei Yu
- Institute of Pharmacy & Pharmacology , Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study , University of South China , Hengyang City , Hunan Province 421001 , P.R. China .
- Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research , 28 Western Changshen Road , Hengyang City , Hunan Province 421001 , P.R. China
| | - Yanchun Li
- Institute of Pharmacy & Pharmacology , Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study , University of South China , Hengyang City , Hunan Province 421001 , P.R. China .
- Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research , 28 Western Changshen Road , Hengyang City , Hunan Province 421001 , P.R. China
| | - Zhenhua Liu
- Institute of Pharmacy & Pharmacology , Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study , University of South China , Hengyang City , Hunan Province 421001 , P.R. China .
- Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research , 28 Western Changshen Road , Hengyang City , Hunan Province 421001 , P.R. China
| | - Binning Zhou
- Institute of Pharmacy & Pharmacology , Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study , University of South China , Hengyang City , Hunan Province 421001 , P.R. China .
- Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research , 28 Western Changshen Road , Hengyang City , Hunan Province 421001 , P.R. China
| | - Yunmei Liu
- Institute of Pharmacy & Pharmacology , Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study , University of South China , Hengyang City , Hunan Province 421001 , P.R. China .
- Hunan Provincial Key Laboratory of Tumor Microenvironment Responsive Drug Research , 28 Western Changshen Road , Hengyang City , Hunan Province 421001 , P.R. China
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Etcheverry ME, Pasquale MA, Bergna C, Ponzinibbio C, Garavaglia M. Photodynamic therapy in 2D and 3D human cervical carcinoma cell cultures employing LED light sources emitting at different wavelengths. ACTA ACUST UNITED AC 2020; 65:015017. [DOI: 10.1088/1361-6560/ab589a] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Platform for ergonomic intraoral photodynamic therapy using low-cost, modular 3D-printed components: Design, comfort and clinical evaluation. Sci Rep 2019; 9:15830. [PMID: 31676807 PMCID: PMC6825190 DOI: 10.1038/s41598-019-51859-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 10/04/2019] [Indexed: 11/13/2022] Open
Abstract
Oral cancer prevalence is increasing at an alarming rate worldwide, especially in developing countries which lack the medical infrastructure to manage it. For example, the oral cancer burden in India has been identified as a public health crisis. The high expense and logistical barriers to obtaining treatment with surgery, radiotherapy and chemotherapy often result in progression to unmanageable late stage disease with high morbidity. Even when curative, these approaches can be cosmetically and functionally disfiguring with extensive side effects. An alternate effective therapy for oral cancer is a light based spatially-targeted cytotoxic therapy called photodynamic therapy (PDT). Despite excellent healing of the oral mucosa in PDT, a lack of robust enabling technology for intraoral light delivery has limited its broader implementation. Leveraging advances in 3D printing, we have developed an intraoral light delivery system consisting of modular 3D printed light applicators with pre-calibrated dosimetry and mouth props that can be utilized to perform PDT in conscious subjects without the need of extensive infrastructure or manual positioning of an optical fiber. To evaluate the stability of the light applicators, we utilized an endoscope in lieu of the optical fiber to monitor motion in the fiducial markers. Here we showcase the stability (less than 2 mm deviation in both horizontal and vertical axis) and ergonomics of our applicators in delivering light precisely to the target location in ten healthy volunteers. We also demonstrate in five subjects with T1N0M0 oral lesions that our applicators coupled with a low-cost fiber coupled LED-based light source served as a complete platform for intraoral light delivery achieving complete tumor response with no residual disease at initial histopathology follow up in these patients. Overall, our approach potentiates PDT as a viable therapeutic option for early stage oral lesions that can be delivered in low resource settings.
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Tracy EC, Bowman MJ, Pandey RK, Baumann H. Cell-specific Retention and Action of Pheophorbide-based Photosensitizers in Human Lung Cancer Cells. Photochem Photobiol 2018; 95:846-859. [PMID: 30378688 DOI: 10.1111/php.13043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 10/18/2018] [Indexed: 12/29/2022]
Abstract
This study determined in primary cultures of human lung cancer cells the cell specificity of chlorin-based photosensitizers. Epithelial cells (ECs) preferentially retained 3-[1-hexyloxyethyl]-2-devinylpyropheophorbide-a (HPPH) and related structural variants. Tumor-associated fibroblasts (Fb) differ from EC by a higher efflux rate of HPPH. Immunoblot analyses indicated dimerization of STAT3 as a reliable biomarker of the photoreaction. Compared to mitochondria/ER-localized photoreaction by HPPH, the photoreaction by lysosomally targeted HPPH-lactose showed a trend toward lower STAT3 cross-linking. Lethal consequence of the photoreaction differed between EC and Fb with the latter cells being more resistant. A survey of lung tumor cases indicated a large quantitative range by which EC retains HPPH. The specificity of HPPH retention defined in vitro could be confirmed in vivo in selected cases grown as xenografts. HPPH retention as a function of the tetrapyrrole structure was evaluated by altering side groups on the porphyrin macrocycle. The presence or absence of a carboxylic acid at position 172 proved to be critical. A benzyl group at position 20 enhanced retention in a subset of cancer cells with low HPPH binding. This study indicated experimental tools that are potentially effective in defining the photosensitizer preference and application for individual patient's cancer lesions.
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Affiliation(s)
- Erin C Tracy
- Department of Molecular and Cellular Biology, Roswell Park Comprehensive Cancer Center (RPCCC), Buffalo, NY
| | - Mary-Jo Bowman
- Department of Molecular and Cellular Biology, Roswell Park Comprehensive Cancer Center (RPCCC), Buffalo, NY
| | - Ravendra K Pandey
- Department of Cell Stress Biology/PDT Center, Roswell Park Comprehensive Cancer Center (RPCCC), Buffalo, NY
| | - Heinz Baumann
- Department of Molecular and Cellular Biology, Roswell Park Comprehensive Cancer Center (RPCCC), Buffalo, NY
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Baskaran R, Lee J, Yang SG. Clinical development of photodynamic agents and therapeutic applications. Biomater Res 2018; 22:25. [PMID: 30275968 PMCID: PMC6158913 DOI: 10.1186/s40824-018-0140-z] [Citation(s) in RCA: 282] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 09/11/2018] [Indexed: 12/20/2022] Open
Abstract
Background Photodynamic therapy (PDT) is photo-treatment of malignant or benign diseases using photosensitizing agents, light, and oxygen which generates cytotoxic reactive oxygens and induces tumour regressions. Several photodynamic treatments have been extensively studied and the photosensitizers (PS) are key to their biological efficacy, while laser and oxygen allow to appropriate and flexible delivery for treatment of diseases. Introduction In presence of oxygen and the specific light triggering, PS is activated from its ground state into an excited singlet state, generates reactive oxygen species (ROS) and induces apoptosis of cancer tissues. Those PS can be divided by its specific efficiency of ROS generation, absorption wavelength and chemical structure. Main body Up to dates, several PS were approved for clinical applications or under clinical trials. Photofrin® is the first clinically approved photosensitizer for the treatment of cancer. The second generation of PS, Porfimer sodium (Photofrin®), Temoporfin (Foscan®), Motexafin lutetium, Palladium bacteriopheophorbide, Purlytin®, Verteporfin (Visudyne®), Talaporfin (Laserphyrin®) are clinically approved or under-clinical trials. Now, third generation of PS, which can dramatically improve cancer-targeting efficiency by chemical modification, nano-delivery system or antibody conjugation, are extensively studied for clinical development. Conclusion Here, we discuss up-to-date information on FDA-approved photodynamic agents, the clinical benefits of these agents. However, PDT is still dearth for the treatment of diseases in specifically deep tissue cancer. Next generation PS will be addressed in the future for PDT. We also provide clinical unmet need for the design of new photosensitizers.
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Affiliation(s)
- Rengarajan Baskaran
- World Class Smart Lab, Department of New Drug Development, Inha University College of Medicine, 366, Seohae-daero, Jung-gu, Incheon, 22332 Republic of Korea
| | - Junghan Lee
- World Class Smart Lab, Department of New Drug Development, Inha University College of Medicine, 366, Seohae-daero, Jung-gu, Incheon, 22332 Republic of Korea
| | - Su-Geun Yang
- World Class Smart Lab, Department of New Drug Development, Inha University College of Medicine, 366, Seohae-daero, Jung-gu, Incheon, 22332 Republic of Korea
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13
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Theodoraki MN, Yerneni SS, Brunner C, Theodorakis J, Hoffmann TK, Whiteside TL. Plasma-derived Exosomes Reverse Epithelial-to-Mesenchymal Transition after Photodynamic Therapy of Patients with Head and Neck Cancer. Oncoscience 2018; 5:75-87. [PMID: 29854876 PMCID: PMC5978437 DOI: 10.18632/oncoscience.410] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 04/21/2018] [Indexed: 12/19/2022] Open
Abstract
Photodynamic therapy (PDT) is a palliative treatment option for head and neck squamous cell carcinoma (HNSCC) patients which induces local inflammation and alters tumor cell morphology. We show that exosomes in plasma of HNSCC patients undergoing PDT reprogram tumor cells towards an epithelial phenotype. Nine HNSCC patients were treated with PDT and plasma was collected prior to and at three timepoints after therapy. Exosome levels of E-Cadherin, N-Cadherin and TGF-β1 were tested by flow cytometry. Exosomes were co-incubated with cancer cells, and changes in expression of EMT markers were evaluated as were proliferation, migration, chemotaxis and invasiveness of tumor cells. Exosomes harvested pre- and 24h after PDT were enriched in N-Cadherin and TGF-β1. They induced the mesenchymal phenotype and up-regulated Vimentin and transcripts for Snail, Twist, α-SMA, Slug and ZEB1 in epithelial tumor cells. These exosomes also enhanced tumor proliferation, migration and invasion. In contrast, exosomes obtained on day 7 or 4-6 weeks after PDT carried E-cadherin, restored epithelial morphology and EpCAM expression in tumor cells, down-regulated expression of mesenchymal genes and inhibited proliferation, migration and invasion. The PDT-mediated conversion from the mesenchymal to epithelial tumor phenotype was mediated by exosomes, which also served as non-invasive biomarkers of this transition.
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Affiliation(s)
- Marie-Nicole Theodoraki
- Department of Pathology, University of Pittsburgh School of Medicine and UPMC Hillman Cancer Center, Pittsburgh, PA 15213, USA.,Department of Otorhinolaryngology, Head and Neck Surgery, University of Ulm, Germany
| | - Saigopalakrishna S Yerneni
- Department of Biomedical Engineering, College of Engineering, Carnegie Mellon University, Pittsburgh, PA 15217, USA
| | - Cornelia Brunner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Ulm, Germany
| | | | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Ulm, Germany
| | - Theresa L Whiteside
- Department of Pathology, University of Pittsburgh School of Medicine and UPMC Hillman Cancer Center, Pittsburgh, PA 15213, USA.,Departments of Immunology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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14
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Enhancement of cancerous cells treatment by applying cold atmospheric plasma and photo dynamic therapy simultaneously. CLINICAL PLASMA MEDICINE 2017. [DOI: 10.1016/j.cpme.2017.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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15
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Theodoraki M, Lorenz K, Lotfi R, Fürst D, Tsamadou C, Jaekle S, Mytilineos J, Brunner C, Theodorakis J, Hoffmann T, Laban S, Schuler P. Influence of photodynamic therapy on peripheral immune cell populations and cytokine concentrations in head and neck cancer. Photodiagnosis Photodyn Ther 2017; 19:194-201. [DOI: 10.1016/j.pdpdt.2017.05.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/02/2017] [Accepted: 05/18/2017] [Indexed: 12/23/2022]
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16
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Abstract
BACKGROUND In considering skin cancer, a number of factors-including effectiveness, simplicity of treatment, cost, and esthetic outcomes-are important to ensure patient's satisfaction. There are several existing interventions, such as electrodessication and curettage, excision, Mohs surgery, radiation therapy, cryotherapy, and topical/oral treatments. Laser therapy has emerged as a new promising alternative that should be explored. OBJECTIVE To review the literature on the dermatological use of laser therapy in the treatment of skin cancer. RESULTS A review of articles available on the MEDLINE and Web of Science databases until May 2017 yielded 24 and 6 studies, respectively, on laser therapy in the treatment of skin cancers, particularly melanoma, basal cell carcinoma, and squamous cell carcinoma. The four laser subtypes included solid-state, diode, dye, and gas lasers. CONCLUSION Review of the literature demonstrates the progress of dermatological understanding of the clinical implications of laser therapy in the treatment of premalignant and malignant neoplasms of the skin, and suggests that this treatment modality might be a viable option for some patients.
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Affiliation(s)
- Fatima N Mirza
- a Department of Dermatology, Yale School of Medicine , Yale University , New Haven , CT , USA.,b Department of Public Health and Primary Care , University of Cambridge , Cambridge , UK
| | - Khalil A Khatri
- c Skin and Laser Surgery Center of New England , Nashua , NH , USA
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17
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Meier D, Botter SM, Campanile C, Robl B, Gräfe S, Pellegrini G, Born W, Fuchs B. Foscan and foslip based photodynamic therapy in osteosarcoma in vitro and in intratibial mouse models. Int J Cancer 2017; 140:1680-1692. [PMID: 27943293 DOI: 10.1002/ijc.30572] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/28/2016] [Accepted: 11/24/2016] [Indexed: 12/14/2022]
Abstract
Current osteosarcoma therapies cause severe treatment-related side effects and chemoresistance, and have low success rates. Consequently, alternative treatment options are urgently needed. Photodynamic therapy (PDT) is a minimally invasive, local therapy with proven clinical efficacy for a variety of tumor types. PDT is cytotoxic, provokes anti-vascular effects and stimulates tumor cell targeting mechanisms of the immune system and, consequently, has potential as a novel therapy for osteosarcoma patients. This study investigated the uptake and the dark- and phototoxicity and cytotoxic mechanisms of the photosensitizer (PS) 5,10,15,20-tetrakis(meta-hydroxyphenyl) chlorine (mTHPC, Foscan) and a liposomal mTHPC formulation (Foslip) in the human 143B and a mouse K7M2-derived osteosaroma cell line (K7M2L2) in vitro. Second, the tumor- and metastasis-suppressive efficacies of mTHPC formulations based PDT and associated mechanisms in intratibial, metastasizing osteosarcoma mouse models (143B/SCID and syngeneic K7M2L2/BALB/c) were studied. The uptake of Foscan and Foslip in vitro was time- and dose-dependent and resulted in mTHPC and light dose-dependent phototoxicity associated with apoptosis. In vivo, the uptake of both i.v. administered mTHPC formulations was higher in tumor than in healthy control tissue. PDT caused significant (Foscan p < 0.05, Foslip p < 0.001) tumor growth inhibition in both models. A significant (Foscan p < 0.001, Foslip p < 0.001) immune system-dependent suppression of lung metastasis was only observed in the K7M2L2/BALB/c model and was associated with a marked infiltration of T-lymphocytes at the primary tumor site. In conclusion, mTHPC-based PDT is effective in clinically relevant experimental osteosarcoma and suppresses lung metastasis in immunocompetent mice with beneficial effects of the liposomal mTHPC formulation Foslip.
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Affiliation(s)
- Daniela Meier
- Laboratory for Orthopedic Research, Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland
| | - Sander M Botter
- Laboratory for Orthopedic Research, Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland
| | - Carmen Campanile
- Laboratory for Orthopedic Research, Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland
| | - Bernhard Robl
- Laboratory for Orthopedic Research, Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland
| | - Susanna Gräfe
- Biolitec Research GmbH, Otto-Schott-Straße 15, Jena, Germany
| | - Giovanni Pellegrini
- Laboratory for Animal Model Pathology, Institute of Veterinary Pathology, University of Zurich, Zurich, Switzerland
| | - Walter Born
- Laboratory for Orthopedic Research, Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland
| | - Bruno Fuchs
- Laboratory for Orthopedic Research, Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland
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18
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Engelberth SA, Hempel N, Bergkvist M. Cationic dendritic starch as a vehicle for photodynamic therapy and siRNA co-delivery. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 168:185-192. [PMID: 28237436 DOI: 10.1016/j.jphotobiol.2017.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/14/2017] [Accepted: 02/17/2017] [Indexed: 12/27/2022]
Abstract
Cationic enzymatically synthesized glycogen (cESG) is a naturally-derived, nano-scale carbohydrate dendrite that has shown promise as a cellular delivery vehicle owing to its flexibility in chemical modifications, biocompatibility and relative low cost. In the present work, cESG was modified and evaluated as a vehicle for tetraphenylporphinesulfonate (TPPS) in order to improve cellular delivery of this photosensitizer and investigate the feasibility of co-delivery with short interfering ribonucleic acid (siRNA). TPPS was electrostatically condensed with cESG, resulting in a sub-50nm particle with a positive zeta potential of approximately 5mV. When tested in normal ovarian surface epithelial and ovarian clear cell carcinoma cell culture models, encapsulation of TPPS in cESG significantly improved cell death in response to light treatment compared to free drug alone. Dosages as low as 0.16μM TPPS resulted in cellular death upon illumination with a 4.8J/cm2 light dosage, decreasing viability by 96%. cESG-TPPS was then further evaluated as a co-delivery system with siRNA for potential combination therapy, by charge-based condensation of an siRNA directed at reducing expression of manganese superoxide dismutase (Sod2) as a proof of principle target. Simultaneous delivery of TPPS and siRNA was achieved, reducing Sod2 protein expression to 48%, while maintaining the photodynamic properties of TPPS under light exposure and maintaining low dark toxicity. This study demonstrates the versatility of cESG as a platform for dual delivery of small molecules and oligonucleotides, and the potential for further development of this system in combination therapy applications.
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Affiliation(s)
- Sarah A Engelberth
- Nanobioscience Constellation, Colleges of Nanoscale Science and Engineering, SUNY Polytechnic Institute, Albany, NY 12203, United States
| | - Nadine Hempel
- Department of Pharmacology, Penn State College of Medicine, Hershey, PA 17033, United States.
| | - Magnus Bergkvist
- Nanobioscience Constellation, Colleges of Nanoscale Science and Engineering, SUNY Polytechnic Institute, Albany, NY 12203, United States.
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19
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Dang J, He H, Chen D, Yin L. Manipulating tumor hypoxia toward enhanced photodynamic therapy (PDT). Biomater Sci 2017; 5:1500-1511. [DOI: 10.1039/c7bm00392g] [Citation(s) in RCA: 199] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This mini-review summarizes various methods for overcoming or utilizing hypoxia for enhanced PDT.
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Affiliation(s)
- Juanjuan Dang
- Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices
- Institute of Functional Nano and Soft Materials (FUNSOM)
- Soochow University
- Suzhou 215123
- P.R. China
| | - Hua He
- Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices
- Institute of Functional Nano and Soft Materials (FUNSOM)
- Soochow University
- Suzhou 215123
- P.R. China
| | - Donglai Chen
- Department of Thoracic Surgery
- Shanghai Pulmonary Hospital
- Tongji University School of Medicine
- Shanghai
- P.R. China
| | - Lichen Yin
- Jiangsu Key Laboratory for Carbon-Based Functional Materials and Devices
- Institute of Functional Nano and Soft Materials (FUNSOM)
- Soochow University
- Suzhou 215123
- P.R. China
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20
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Volgger V, Betz CS. Photodynamic therapy in the upper aerodigestive tract. Overview and outlook. JOURNAL OF BIOPHOTONICS 2016; 9:1302-1313. [PMID: 27010591 DOI: 10.1002/jbio.201600036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 02/28/2016] [Accepted: 03/01/2016] [Indexed: 06/05/2023]
Abstract
The gold standard in the treatment of (pre)malignancies of the upper aerodigestive tract (UADT) is either surgery or (chemo)radiotherapy. Nevertheless, there are special indications where an alternative treatment, such as photodynamic therapy (PDT), might be as effective for and better tolerated by the patients concerned. This article aims to present a contemporary and comprehensive review on the role of photodynamic therapy in the treatment of (pre)malignancies of the UADT. PubMed was searched for "photodynamic therapy larynx/oral cavity/oropharynx/head and neck" in 01/2016. PDT can be efficient in the treatment of recurrent, residual or multiple carcinomas of the UADT without other treatment options. It has also been used with success in the treatment of early oral or laryngeal carcinomas, widespread precancerous lesions or "difficult-to-treat" skin cancer, even though these treatments are off-label. For now, unsolved scientific and economical challenges hinder the methods spread. In special cases, PDT is a highly effective method to treat head and neck (pre)malignancies. Nevertheless, further clinical studies are needed to better define its true value in head and neck oncology.
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Affiliation(s)
- Veronika Volgger
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Großhadern, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Christian Stephan Betz
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Großhadern, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
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21
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Andreadis D, Pavlou AM, Sotiriou E, Vrani F, Ioannides D, Kolokotronis A. Utility of photodynamic therapy for the management of oral potentially malignant disorders and oral cancer. TRANSLATIONAL RESEARCH IN ORAL ONCOLOGY 2016. [DOI: 10.1177/2057178x16669161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Photodynamic therapy (PDT), defined as “the light-induced inactivation of cells, microorganisms, or molecules,” combines the use of a photosensitive agent or photosensitizer (PS) activated by irradiation with a light source to produce reactive oxygen species and highly reactive singlet oxygen. PDT has been used for the treatment of different oral diseases with promising results. This review describes the basic principles of PDT, including the nature of PS and the light sources, and focuses on evaluating the efficacy of this method, according to the existing data, for the treatment of different oral diseases. PubMed was used as the source of the relevant literature, about the clinical application of PDT in actinic cheilitis (AC), leukoplakia, oral lichen planus, oral lichenoid lesions, and oral cancer. Complete response to PDT as high as 100% has been reported not only in cases of AC but also in dysplasias/carcinomas in situ, T1N0, and T2N0. According to the available data, PDT appears to be a safe, well-tolerated therapy with limited adverse effects and excellent cosmetic outcome. Although PDT is a very promising therapy, further research is needed in order to investigate the cases that fail to respond, to examine the long-term prognosis for cases of reported complete response and thus avoid the future recurrence of diseases.
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Affiliation(s)
- Dimitrios Andreadis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Achilleia-Maria Pavlou
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Sotiriou
- First Department of Dermatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fani Vrani
- First Department of Dermatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Ioannides
- First Department of Dermatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Kolokotronis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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22
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Shafirstein G, Rigual NR, Arshad H, Cooper MT, Bellnier DA, Wilding G, Tan W, Merzianu M, Henderson BW. Photodynamic therapy with 3-(1'-hexyloxyethyl) pyropheophorbide-a for early-stage cancer of the larynx: Phase Ib study. Head Neck 2015; 38 Suppl 1:E377-83. [PMID: 25580824 PMCID: PMC4499022 DOI: 10.1002/hed.24003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2015] [Indexed: 12/02/2022] Open
Abstract
Background The purpose of this study was for us to report results regarding the safety of 3‐(1′‐hexyloxyethyl) pyropheophorbide‐a (HPPH) mediated photodynamic therapy (PDT) in early laryngeal disease, and offer preliminary information on treatment responses. Methods A single‐institution, phase Ib, open label, noncomparative study of HPPH‐PDT in patients with high‐risk dysplasia, carcinoma in situ, and T1 squamous cell carcinoma (SCC) of the larynx. The primary outcomes were safety and maximum tolerated dose (MTD), and the secondary outcome was response. Results Twenty‐nine patients and 30 lesions were treated. The most common adverse event (AE) was transient hoarseness of voice. Severe edema, requiring tracheostomy, was the most serious AE, which occurred in 2 patients within several hours of therapy. The MTD was 100 J/cm2. Patients with T1 SCC seemed to have good complete response rate (82%) to HPPH‐PDT at MTD. Conclusion HPPH‐PDT can be safely used to treat early‐stage laryngeal cancer, with potential efficacy. © 2015 The Authors Head & Neck Published by Wiley Periodicals, Inc. Head Neck38: E377–E383, 2016
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Affiliation(s)
- Gal Shafirstein
- Photodynamic Therapy Center, Roswell Park Cancer Institute, Buffalo, New York.,Department of Cell Stress Biology, Roswell Park Cancer Institute, Buffalo, New York.,Department of Head and Neck Surgery, Roswell Park Cancer Institute, Buffalo, New York
| | - Nestor R Rigual
- Photodynamic Therapy Center, Roswell Park Cancer Institute, Buffalo, New York
| | - Hassan Arshad
- Photodynamic Therapy Center, Roswell Park Cancer Institute, Buffalo, New York.,Department of Head and Neck Surgery, Roswell Park Cancer Institute, Buffalo, New York
| | - Michele T Cooper
- Photodynamic Therapy Center, Roswell Park Cancer Institute, Buffalo, New York
| | - David A Bellnier
- Photodynamic Therapy Center, Roswell Park Cancer Institute, Buffalo, New York.,Department of Cell Stress Biology, Roswell Park Cancer Institute, Buffalo, New York
| | - Gregory Wilding
- Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, New York
| | - Wei Tan
- Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, New York
| | - Mihai Merzianu
- Department of Pathology, Roswell Park Cancer Institute, Buffalo, New York
| | - Barbara W Henderson
- Photodynamic Therapy Center, Roswell Park Cancer Institute, Buffalo, New York
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23
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Xie H, Svenmarker P, Axelsson J, Gräfe S, Kyriazi M, Bendsoe N, Andersson-Engels S, Svanberg K. Pharmacokinetic and biodistribution study following systemic administration of Fospeg®--a Pegylated liposomal mTHPC formulation in a murine model. JOURNAL OF BIOPHOTONICS 2015; 8:142-152. [PMID: 24375973 DOI: 10.1002/jbio.201300133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 11/01/2013] [Accepted: 11/15/2013] [Indexed: 06/03/2023]
Abstract
Fospeg® is a newly developed photosensitizer formulation based on meso-tetra(hydroxyphenyl)chlorin (mTHPC), with hydrophilic liposomes to carry the hydrophobic photosensitizer to the target tissue. In this study the pharmacokinetics and biodistribution of Fospeg® were investigated by high performance liquid chromatography at various times (0.5-18 hours) following systemic i.v. administration. As a model an experimental HT29 colon tumor in NMRI nu/nu mice was employed. Our study indicates a higher plasma peak concentration, a longer circulation time and a better tumor-to-skin ratio than those of Foslip®, another liposomal mTHPC formulation. Data from ex vivo tissue fluorescence and reflectance imaging exhibit good correlation with chemical extraction. Our results have shown that optical imaging provides the potential for fluorophore quantification in biological tissues.
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Affiliation(s)
- Haiyan Xie
- Department of Physics, Lund University, P.O. Box 118, 22100, Lund, Sweden.
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24
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von Beckerath MP, Reizenstein JA, Berner AL, Nordqvist KWO, Landström FJ, Löfgren AL, Möller CG. Outcome of primary treatment of early laryngeal malignancies using photodynamic therapy. Acta Otolaryngol 2014; 134:852-8. [PMID: 24856450 DOI: 10.3109/00016489.2014.906748] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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25
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Mohanty N, Jalaluddin MD, Kotina S, Routray S, Ingale Y. Photodynamic therapy: the imminent milieu for treating oral lesions. J Clin Diagn Res 2013; 7:1254-7. [PMID: 23905154 PMCID: PMC3708249 DOI: 10.7860/jcdr/2013/5767.3088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 03/14/2013] [Indexed: 11/24/2022]
Abstract
Photodynamic therapy (PDT) is used in curative and palliative treatment of head and neck squamous cell carcinoma (HNSCC) and other oral lesions. Oral infections (such as mucosal and endodontic infections, periodontal diseases, caries, and peri-implantitis) are among the specific targets where PDT can be applied Photodynamic therapy (PDT) efficacy depends on the local dose deposited in the lesion as well as oxygen availability in the lesion. Further long-term clinical studies are necessary in establishing a more specific place of the technique in the field of dentistry.
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Affiliation(s)
- Neeta Mohanty
- HOD & Professor, Department of Oral Pathology & Microbiology, Institute of Dental Sciences, Bhubaneswar, Odisha, India
| | - MD Jalaluddin
- Reader, Department of Periodontics & Oral Implantology Kalinga Institute of Dental Sciences, Khushabhadra, Campus-5, KIIT University, Patia, Bhubaneswar, Odisha-750024, India
| | - Sreekanth Kotina
- Senior Lecturer, Department of Oral Pathology & Microbiology, GITAM Dental College & Hospital, Gandhinagar Campus, Rushikonda, Vishakapatanam, Andhra Pradesh-530045, India
| | - Samapika Routray
- Senior Lecturer, Department of Oral Pathology & Microbiology, GITAM Dental College & Hospital, Gandhinagar Campus, Rushikonda, Vishakapatanam, Andhra Pradesh-530045, India
| | - Yashwant Ingale
- HOD, Department of Dentistry, Y.C.M Hospital, Pimpri, Pune, Maharastra, India
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26
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Kim JY, Choi JE, Ahn HH, Kye YC, Seo SH. A case of squamous cell carcinoma treated with chlorine photodynamic therapy. Ann Dermatol 2012. [PMID: 23197925 PMCID: PMC3505790 DOI: 10.5021/ad.2012.24.4.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Jong Yeob Kim
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
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27
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de Visscher SAHJ, Dijkstra PU, Tan IB, Roodenburg JLN, Witjes MJH. mTHPC mediated photodynamic therapy (PDT) of squamous cell carcinoma in the head and neck: a systematic review. Oral Oncol 2012; 49:192-210. [PMID: 23068024 DOI: 10.1016/j.oraloncology.2012.09.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 09/17/2012] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Photodynamic therapy (PDT) is used in curative and palliative treatment of head and neck squamous cell carcinoma (HNSCC). To evaluate available evidence on the use of mTHPC (Foscan®) mediated PDT, we conducted a review of the literature. MATERIALS AND METHODS A systematic review was performed by searching seven bibliographic databases on database specific mesh terms and free text words in the categories; "head and neck neoplasms", "Photodynamic Therapy" and "Foscan". Papers identified were assessed on several criteria by two independent reviewers. RESULTS The search identified 566 unique papers. Twelve studies were included for our review. Six studies reported PDT with curative intent and six studies reported PDT with palliative intent, of which three studies used interstitial PDT. The studies did not compare PDT to other treatments and none exceeded level 3 using the Oxford levels of evidence. Pooling of data (n=301) was possible for four of the six studies with curative intent. T1 tumors showed higher complete response rates compared to T2 (86% vs 63%). PDT with palliative intent was predominantly used in patients unsuitable for further conventional treatment. After PDT, substantial tumor response and increase in quality of life was observed. Complications of PDT were mostly related to non-compliance to light restriction guidelines. CONCLUSION The studies on mTHPC mediated PDT for HNSCC are not sufficient for adequate assessment of the efficacy for curative intent. To assess efficacy of PDT with curative intent, high quality comparative, randomized studies are needed. Palliative treatment with PDT seems to increase the quality of life in otherwise untreatable patients.
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Affiliation(s)
- S A H J de Visscher
- Department of Oral and Maxillofacial Surgery, Division of Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
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Durbec M, Cosmidis A, Fuchsmann C, Ramade A, Céruse P. Efficacy and safety of photodynamic therapy with temoporfin in curative treatment of recurrent carcinoma of the oral cavity and oropharynx. Eur Arch Otorhinolaryngol 2012; 270:1433-9. [PMID: 22927020 DOI: 10.1007/s00405-012-2083-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 06/06/2012] [Indexed: 12/21/2022]
Abstract
Therapeutic options for recurrent carcinoma of the upper aérodigestive tract (UADT) are limited. The prognosis of these tumours remains poor with significant rate of recurrence and a lower median survival time. Photodynamic therapy (PDT) is a relatively new therapeutic alternative which combines the use of a photosensitising agent and light to induce a cytotoxic effect on the tissues. This is a retrospective single-centre study carried out in patients with a recurrence of an oral cavity or oropharyngeal carcinoma or a second appearance of tumour in a previously irradiated area. There were no metastases in lymph nodes or other organs. Laser treatment was carried out 96 h after temoporfin (Foscan(®)) injection. In our series we had 14 cases with a complete response, 1 partial response. Overall survival at 1 year was 72 % and 36 % at 5 years. Disease-specific survival at 1 year was 82 % and 45 % at 5 years. Recurrence-free survival at 1 year was 52 % and 34 % at 5 years. Side effects mainly described are pain in the area of illumination, well controlled. PDT with Foscan(®) gives useful results in terms of survival and improvement in quality of life with few adverse events or severe complications. The fact that it has low toxicity and that treatment sessions can be repeated mean it should be considered in the therapeutic armamentarium for recurrent carcinoma of the UADT.
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Affiliation(s)
- M Durbec
- ENT Department, Hospices Civils de Lyon, Centre hospitalier Lyon Sud, Pierre-Bénite Cedex, France.
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A matched cohort comparison of mTHPC-mediated photodynamic therapy and trans-oral surgery of early stage oral cavity squamous cell cancer. Eur Arch Otorhinolaryngol 2012; 270:1093-7. [PMID: 22773192 PMCID: PMC3580137 DOI: 10.1007/s00405-012-2104-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 06/21/2012] [Indexed: 11/05/2022]
Abstract
Photodynamic therapy (PDT) of early stage oral cavity tumors have been thoroughly reported. However, statistical comparison of PDT to the surgical treatment is not available in published literature. We have identified and matched cohorts of patients with early stage oral cavity cancers undergoing surgery (n = 43) and PDT (n = 55) from a single institute experience. The groups are matched demographically and had the same pre-treatment screening and follow-up schedule. Both groups consisted only of tumors thinner than 5 mm to ensure comparability. The endpoints were local disease free survival, disease free survival, overall survival and response to initial treatment. Local disease free survival at 5 years were 67 and 74 % for PDT and surgery groups, respectively [univariate HR = 1.9 (p = 0.26), multivariable HR = 2.7 (p = 0.13)]. Disease free survival at 5 years are 47 and 53 % for PDT and surgery groups, respectively [univariate HR = 0.8 (p = 0.52), multivariable HR = 0.75 (p = 0.45)]. Overall survival was 83 and 75 % for PDT and surgery groups, respectively [(univariate HR = 0.5 (p = 0.19), multivariable HR = 0.5 (p = 0.17)]. In the PDT group, six patients (11 %) and in the surgery group 11 patients (26 %) had to receive additional treatments after the initial. All of the tested parameters did not have statistical significant difference. Although there is probably a selection bias due to the non-randomized design, this study shows that PDT of early stage oral cavity cancer is comparable in terms of disease control and survival to trans-oral resection and can be offered as an alternative to surgical treatment.
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Sardella A, Carrassi A, Tarozzi M, Lodi G. Bisphosphonate-related osteonecrosis of the jaws associated with photodynamic therapy. J Oral Maxillofac Surg 2011; 69:e314-6. [PMID: 21939806 DOI: 10.1016/j.joms.2011.06.219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 06/21/2011] [Accepted: 06/21/2011] [Indexed: 10/17/2022]
Affiliation(s)
- Andrea Sardella
- Department of Medicine, Surgery and Dentistry, Unit of Oral Medicine, Oral Pathology and Gerodontology, University of Milan, Milan, Italy.
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Senge MO, Brandt JC. Temoporfin (Foscan®, 5,10,15,20-tetra(m-hydroxyphenyl)chlorin)--a second-generation photosensitizer. Photochem Photobiol 2011; 87:1240-96. [PMID: 21848905 DOI: 10.1111/j.1751-1097.2011.00986.x] [Citation(s) in RCA: 221] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This review traces the development and study of the second-generation photosensitizer 5,10,15,20-tetra(m-hydroxyphenyl)chlorin through to its acceptance and clinical use in modern photodynamic (cancer) therapy. The literature has been covered up to early 2011.
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Affiliation(s)
- Mathias O Senge
- Medicinal Chemistry, Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin, St. James's Hospital, Dublin 8, Ireland.
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Lim SH, Lee HB, Ho ASH. A new naturally derived photosensitizer and its phototoxicity on head and neck cancer cells. Photochem Photobiol 2011; 87:1152-8. [PMID: 21534974 DOI: 10.1111/j.1751-1097.2011.00939.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In our screening for photosensitizers from natural resources, 15(1)-hydroxypurpurin-7-lactone ethyl methyl diester (compound 1) was isolated for the first time from an Araceae plant. To evaluate the efficacy of compound 1 as a photosensitizer for head and neck cancers, compound 1 was studied in reference to a known photosensitizer pheophorbide-a (Pha), in terms of photophysical properties, singlet oxygen generation and in in vitro experiments (intracellular uptake and phototoxicity assays) in two oral (HSC2 and HSC3) and two nasopharyngeal (HK1 and C666-1) cancer cell lines. In this study, compound 1 exhibited higher intracellular uptake over 24 h compared with Pha in both HSC3 and HK1 cells. When activated by ≥4.8 J cm(-2) of light, compound 1 was slightly more potent as a photosensitizer than Pha by consistently having marginally lower IC(50) values across different cell lines. In flow cytometry experiments to study the mechanism of photoactivated cell death in HSC3, compound 1 was observed to induce more pronounced apoptosis compared with Pha, which may have been driven by the transient G(2)/M cell cycle block which was also observed. These promising results on compound 1 warrant its further investigation as a clinically useful photodynamic therapy agent for head and neck cancer.
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Affiliation(s)
- Siang Hui Lim
- Cancer Research Initiatives Foundation (CARIF), Sime Darby Medical Centre, Subang Jaya, Selangor, Malaysia
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Lee J, Moon C. Current status of experimental therapeutics for head and neck cancer. Exp Biol Med (Maywood) 2011; 236:375-89. [PMID: 21427235 DOI: 10.1258/ebm.2010.010354] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
As with many cancers, early detection of head and neck cancer increases a patient's survival rate. If diagnosed early, its five-year survival nears 90% with standard therapy alone. Unfortunately, the average survival rate for head and neck cancer is low due to the difficulty in early detection and achieving a sustainable response. Conventional treatments are not adequate for the majority of advanced or recurrent head and neck cancer patients because of the remarkable resistance of tumors to chemotherapy and radiation, and the situation is especially devastating for the first time treatment failure. The major limitations of these treatments are the lack of specificity for the tumor cell and unacceptable toxicity to the patient. As a result, current research in therapeutics for advanced, chemotherapy-resistant or recurrent head and neck cancer patients has focused on new treatment modalities that exploit biological differences between tumor and normal cells. These therapies include monoclonal antibodies, molecular inhibitors, gene therapy and photodynamic therapy. This article reviews the current preclinical and clinical evidence of these experimental therapeutics as they relate to head and neck cancer.
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Affiliation(s)
- Juna Lee
- Graduate Program in Human Genetics, The Johns Hopkins University School of Medicine and The Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21218, USA
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Compagnin C, Moret F, Celotti L, Miotto G, Woodhams JH, MacRobert AJ, Scheglmann D, Iratni S, Reddi E. Meta-tetra(hydroxyphenyl)chlorin-loaded liposomes sterically stabilised with poly(ethylene glycol) of different length and density: characterisation, in vitro cellular uptake and phototoxicity. Photochem Photobiol Sci 2011; 10:1751-9. [DOI: 10.1039/c1pp05163f] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Schweitzer VG, Somers ML. Photofrin-mediated photodynamic therapy for treatment of early stage laryngeal malignancies. Oncol Rev 2010. [DOI: 10.1007/s12156-010-0059-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Karakullukcu B, van Oudenaarde K, Copper MP, Klop WMC, van Veen R, Wildeman M, Bing Tan I. Photodynamic therapy of early stage oral cavity and oropharynx neoplasms: an outcome analysis of 170 patients. Eur Arch Otorhinolaryngol 2010; 268:281-8. [PMID: 20706842 PMCID: PMC3021196 DOI: 10.1007/s00405-010-1361-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Accepted: 08/02/2010] [Indexed: 11/01/2022]
Abstract
The indications of photodynamic therapy (PDT) of oral cavity and oropharynx neoplasms are not well defined. The main reason is that the success rates are not well established. The current paper analyzes our institutional experience of early stage oral cavity and oropharynx neoplasms (Tis-T2) to identify the success rates for each subgroup according to T stage, primary or non-primary treatment and subsites. In total, 170 patients with 226 lesions are treated with PDT. From these lesions, 95 are primary neoplasms, 131 were non-primaries (recurrences and multiple primaries). The overall response rate is 90.7% with a complete response rate of 70.8%. Subgroup analysis identified oral tongue, floor of mouth sites with more favorable outcome. PDT has more favorable results with certain subsites and with previously untreated lesions. However, PDT can find its place for treating lesions in previously treated areas with acceptable results.
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Affiliation(s)
- Baris Karakullukcu
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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Abstract
PURPOSE OF REVIEW This paper reviews the advances in surgery in head and neck cancer patients. RECENT FINDINGS Sentinel node biopsy is a promising diagnostic technique to detect occult lymph node metastases, especially in oral carcinomas. Fludeoxyglucose-PET seems to be useful in detecting recurrent (laryngeal) carcinoma after radiotherapy. The role of fludeoxyglucose-PET to detect residual disease in the neck after radiotherapy with or without chemotherapy is not yet clear. The armamentarium of reconstructive surgery is still expanding. Endonasal endoscopic, robotic surgery and image-guided surgery are used as minimal invasive surgery in selected patients. Other advances include photodynamic therapy, ultrasonic surgery and mechanical sutures. SUMMARY New diagnostic techniques are used to avoid futile extensive surgery. Technical improvements have been made to treat head and neck cancer patients with minimal invasive surgery. Large prospective trials are needed to determine the indications for each technique.
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Oral mucous squamous cell carcinoma-an anticipated consequence of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED). J Am Acad Dermatol 2010; 62:864-8. [PMID: 20304522 DOI: 10.1016/j.jaad.2009.06.061] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Revised: 06/16/2009] [Accepted: 06/18/2009] [Indexed: 11/20/2022]
Abstract
Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare autosomal recessive disease caused by mutations in the AIRE gene. We report the case of a female patient with a 967-979del13 mutation in the AIRE gene. Her medical history included autoimmune hypoparathyroidism, Addison disease, and chronic mucocutaneous candidiasis. At the age of 40, she developed multiple white verrucous plaques on the oral mucosa. Histologically, the lesions appeared as moderately differentiated squamous cell carcinomas. The patient subsequently developed multiple local recurrences and therefore required repeated surgery. Notably, a higher incidence rate of oral and esophageal squamous cell carcinoma has been observed in this syndrome. However, the critical pathogenetic pathways implicated in squamous cell carcinoma development in APECED are far from being well understood.
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