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Villa A, William WN, Hanna GJ. Cancer Precursor Syndromes and Their Detection in the Head and Neck. Hematol Oncol Clin North Am 2024; 38:813-830. [PMID: 38705773 DOI: 10.1016/j.hoc.2024.04.001] [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] [Indexed: 05/07/2024]
Abstract
This article explores the multifaceted landscape of oral cancer precursor syndromes. Hereditary disorders like dyskeratosis congenita and Fanconi anemia increase the risk of malignancy. Oral potentially malignant disorders, notably leukoplakia, are discussed as precursors influenced by genetic and immunologic facets. Molecular insights delve into genetic mutations, allelic imbalances, and immune modulation as key players in precancerous progression, suggesting potential therapeutic targets. The article navigates the controversial terrain of management strategies of leukoplakia, encompassing surgical resection, chemoprevention, and immune modulation, while emphasizing the ongoing challenges in developing effective, evidence-based preventive approaches.
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Affiliation(s)
- Alessandro Villa
- Oral Medicine, Oral Oncology and Dentistry, Miami Cancer Institute, Baptist Health South Florida, 8900 N. Kendall Drive. Miami, FL 33176, USA; Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - William N William
- Thoracic Oncology Program, Grupo Oncoclínicas Grupo Oncoclínicas, Av. Pres. Juscelino Kubitschek, 510, 2º andar, São Paulo, São Paulo 04543-906, Brazil
| | - Glenn J Hanna
- Department of Medical Oncology, Center for Head & Neck Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Dana Building, Room 2-140. Boston, MA 02215, USA.
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Sroussi H, Villa A, Alhadlaq MA, Ikeda K, Veluppillai S, Treister N, Monreal AV, Vacharotayangul P, Lodolo M, Woo SB. Imiquimod for the treatment of oral leukoplakia: A two-center retrospective study. Oral Dis 2024. [PMID: 39007165 DOI: 10.1111/odi.15069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/22/2024] [Accepted: 07/03/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVES We aimed to assess the effectiveness of the use of topical imiquimod for the management of oral leukoplakia (OL). METHODS This was a retrospective study. Medical chart reviews were conducted to identify patients with biopsy-proven OL treated with topical 5% imiquimod. Data included OL characteristics, histopathological diagnosis, treatment outcome, and adverse events (AEs). Treatment response was assessed by measuring the percentage reduction in the size of OL lesions. RESULTS 33 patients (51.5% females; median age: 65 years) with 38 lesions were included. OLs were either localized (23.7%) or multifocal lesions (76.3%), with the majority on the gingiva (86.8%). Pretreatment histopathological diagnoses were dysplasia in 84.2% and nonreactive hyperkeratosis in 15.8%. Most regimens consisted of 60-minute applications, 5-days-a-week, for 6 weeks. At the end of treatment, 81.6% of 38 lesions showed a reduction in size with 68.4% exhibiting ≥50% reduction in size, and 42.1% exhibiting complete resolution. Application site reactions were the most common with pain/soreness/sensitivity occurring in 86.8%. Fatigue was the most frequently reported systemic AE (28.9%). CONCLUSION Two-thirds of OL lesions had ≥50% reduction in size. Most AEs were temporary and resolved upon treatment discontinuation. Prospective studies are needed to further assess Imiquimod's effectiveness in OL management.
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Affiliation(s)
- Herve Sroussi
- Brigham and Women's Hospital, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Alessandro Villa
- Miami Cancer Institute, Miami, Florida, USA
- Department of Orofacial Sciences, UCSF, San Francisco, California, USA
| | - Malak Adel Alhadlaq
- Brigham and Women's Hospital, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Kentaro Ikeda
- Brigham and Women's Hospital, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | | | - Nathaniel Treister
- Brigham and Women's Hospital, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | | | - Piamkamon Vacharotayangul
- Brigham and Women's Hospital, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Michele Lodolo
- Department of Orofacial Sciences, UCSF, San Francisco, California, USA
| | - Sook-Bin Woo
- Brigham and Women's Hospital, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Naara S, Andrews C, Sikora A, Williams M, Chambers M, Myers J, Amit M. Oral Pre-malignancy: An Update on Novel Therapeutic Approaches. Curr Oncol Rep 2024:10.1007/s11912-024-01562-1. [PMID: 38865005 DOI: 10.1007/s11912-024-01562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE OF REVIEW This review aims to provide a comprehensive overview of the current advances in managing and preventing progression of oral potentially malignant disorders (OPMDs), focusing on their histological and clinicopathological features, and management. RECENT FINDINGS Recent studies, including a multicenter cross-sectional study, have identified oral leukoplakia as the most prevalent form of OPMD, comprising over half of the cases examined. Advances in histological grading, specifically the World Health Organization's three-tier system (mild, moderate, and severe dysplasia), have significantly enhanced the accuracy of risk assessment for malignant transformation. Additionally, treatments such as surgical interventions, photodynamic therapy, and chemopreventive and molecularly targeted agents are being evaluated for their safety and efficacy as well as, immune checkpoint inhibitors being evaluated as potential preventive strategies to halt the progression of OPMDs. The management of OPMDs remains challenging due to the lack of standardized screening protocols and varied clinical management approaches. Despite this, recent advancements in diagnostic grading and therapeutic interventions provide a framework for improved treatment outcomes. Continued research into the molecular and cellular mechanisms driving development and progression of OPMDs and innovative treatment trials are essential to optimize strategies that prevent malignant progression and thereby reduce the global health burden of oral cancer.
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Affiliation(s)
- Shorook Naara
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Clara Andrews
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew Sikora
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Michelle Williams
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Mark Chambers
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey Myers
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Moran Amit
- The Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
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Wang F, Song Y, Xu H, Liu J, Tang F, Yang D, Yang D, Liang W, Ren L, Wang J, Luo X, Zhou Y, Zeng X, Dan H, Chen Q. Prediction of the short-term efficacy and recurrence of photodynamic therapy in the treatment of oral leukoplakia based on deep learning. Photodiagnosis Photodyn Ther 2024; 48:104236. [PMID: 38851310 DOI: 10.1016/j.pdpdt.2024.104236] [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: 04/07/2024] [Revised: 05/28/2024] [Accepted: 06/05/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND The treatment of oral leukoplakia (OLK) with aminolaevulinic acid photodynamic therapy (ALA-PDT) is widespread. Nonetheless, there is variation in efficacy. Therefore, this study constructed a model for predicting the short-term efficacy and recurrence of OLK after ALA-PDT. METHODS The short-term efficacy and recurrence of ALA-PDT were calculated by statistical analysis, and the relevant influencing factors were analyzed by Logistic regression and COX regression model. Finally, prediction models for total response (TR) rate, complete response (CR) rate and recurrence in OLK patients after ALA-PDT treatment were established. Features from pathology sections were extracted using deep learning autoencoder and combined with clinical variables to improve prediction performance of the model. RESULTS The logistic regression analysis showed that the non-homogeneous (OR: 4.911, P: 0.023) OLK and lesions with moderate to severe epithelial dysplasia (OR: 4.288, P: 0.042) had better short-term efficacy. The area under receiver operating characteristic curve (AUC) of CR, TR and recurrence predict models after the ALA-PDT treatment of OLK patients is 0.872, 0.718, and 0.564, respectively. Feature extraction revealed an association between inflammatory cell infiltration in the lamina propria and recurrence after PDT. Combining clinical variables and deep learning improved the performance of recurrence model by more than 30 %. CONCLUSIONS ALA-PDT has excellent short-term efficacy in the management of OLK but the recurrence rate was high. Prediction model based on clinicopathological characteristics has excellent predictive effect for short-term efficacy but limited effect for recurrence. The use of deep learning and pathology images greatly improves predictive value of the models.
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Affiliation(s)
- Fei Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Yansong Song
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Hao Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Jiaxin Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Fan Tang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China; Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou 310000, PR China
| | - Dan Yang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Dan Yang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Wenhui Liang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Ling Ren
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Jiongke Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Xiaobo Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Yu Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China.
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China.
| | - Qianming Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, PR China; Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou 310000, PR China.
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Peralta-Mamani M, Silva BMDA, Honório HM, Rubira-Bullen IRF, Hanna R, Silva PSSDA. CLINICAL EFFICACY OF PHOTODYNAMIC THERAPY IN MANAGEMENT OF ORAL POTENTIALLY MALIGNANT DISORDERS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2024; 24:101899. [PMID: 38821659 DOI: 10.1016/j.jebdp.2023.101899] [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: 12/08/2022] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 06/02/2024]
Abstract
OBJECTIVES Despite phototherapy (in the form of photodynamic therapy (PDT)-mediated oxidative stress) being utilized in the management of oral potentially malignant disorders (OPMDs), the evidence of certainty remains unclear. Hence, this systematic review and meta-analysis (PROSPERO # CRD42021218748) is aimed to evaluate the clinical efficacy of PDT-induced oxidative stress in OPMDs METHODS: PubMed, Embase, Web of Science, Scopus, and Cochrane Library databases were searched without restriction of language or year of publication. In addition, gray literature was searched and a manual search was performed. Two independent reviewers screened all the studies, assessing data extraction, risk of bias and certainty of evidence. A narrative synthesis was carried out. For the meta-analysis, random effects were considered to determine the prevalence of a total and a partial remission (PR) of oral potentially malignant disorders (OPMDs). The certainty of evidence was explored using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS Twenty-three studies were included in the qualitative and quantitative syntheses. A total of 880 patients were included (564 males; 218 females) with an age range between 24 and 89-years-old. The results showed the prevalence of the total and partial remissions respectively for the following OPMLs: actinic cheilitis (AC): 69.9% and 2.4%; oral leukoplakia (OL): 44% and 36.9%; oral verrucous hyperplasia (OVH): 98.5%; oral erythroleukoplakia (OEL): 92.1% and 7.9%. The prevalence of no remission of OL was 18.8%. CONCLUSIONS PDT demonstrated significant results in clinical remission of OPMDs and most of the eligible studies have shown a total or a partial remission of the included lesions, but at a low or a very low certainty of evidence. Hence, further clinical studies with robust methodology are warranted to offer further validated data. Also, further evidence is required to understand further the mechanism of PDT-induced oxidative stress.
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Affiliation(s)
- Mariela Peralta-Mamani
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | - Bruna Machado DA Silva
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | | | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy; Department of Restorative Dental Sciences, UCL-Eastman Dental Institute, Faculty of Medical Sciences, London, UK; Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London UK.
| | - Paulo Sergio Santos DA Silva
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
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Liu W, Zhang X, Shen X, Liu L. Evaluating photodynamic therapy for oral precancerous lesions: Highlighting outcome measure of malignant transformation. J Dent Sci 2024; 19:631-636. [PMID: 38303828 PMCID: PMC10829732 DOI: 10.1016/j.jds.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/12/2023] [Indexed: 02/03/2024] Open
Abstract
The main outcome measure assessed in previous studies on photodynamic therapy (PDT) for oral precancerous lesions (OPL) is clinical response based on the alteration in lesion size after treatment. However, the primary and secondary outcome measures of the interventions for OPL should be malignant transformation and recurrence. Thus, the objective of this short communication is to summarize the evidence on PDT in preventing the recurrence and malignant transformation of OPL. There were 16 eligible studies which addressed the issue of OPL patients who received PDT with recurrence outcome, and the pooled recurrence rate (95% confidence interval) was analyzed to be 20.1% (16.2-24.6%). Notably, only 1 study reported that 7.5% of malignant transformation rate for OPL received PDT. These should be interpreted with caution due to low-level evidence, such as differences in study design, clinical and pathological features of patients enrolled, limited sample size, short follow-up time. Given few evaluated the effect of PDT on malignant transformation, we highlight that this primary outcome measure of OPL needs to be investigated in further well-designed longitudinal studies with adequate follow-up periods.
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Affiliation(s)
- Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Fengcheng Hospital of Fengxian District, Shanghai Ninth People’s Hospital Fengcheng Branch Hospital, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaochen Zhang
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuemin Shen
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral Mucosal Diseases, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liu Liu
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Liu W, Zhang X, Shi L, Shen X. Whether cryosurgery for oral premalignant lesions influences the outcome of malignant transformation. Int J Surg 2023; 109:3219-3221. [PMID: 37318841 PMCID: PMC10583929 DOI: 10.1097/js9.0000000000000549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Center of Head and Neck Oncology Clinical and Translational Science
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xiaochen Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Center of Head and Neck Oncology Clinical and Translational Science
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Linjun Shi
- Department of Oral Mucosal Diseases, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xuemin Shen
- Department of Oral Mucosal Diseases, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
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Zhang R, Gao T, Wang D. Photodynamic therapy (PDT) for oral leukoplakia: a systematic review and meta-analysis of single-arm studies examining efficacy and subgroup analyses. BMC Oral Health 2023; 23:568. [PMID: 37574560 PMCID: PMC10424357 DOI: 10.1186/s12903-023-03294-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/07/2023] [Indexed: 08/15/2023] Open
Abstract
OBJECTIVE This study aims to evaluate the efficacy of photodynamic therapy (PDT) in the treatment of oral leukoplakia and explore the subgroup factors that may influence its effectiveness. METHODS A systematic search was conducted in PubMed, Embase, the Cochrane Library, and Web of Science databases to identify relevant studies. Meta-analysis was performed using Stata15.0 software. Cochran's Q test and I2 statistics were used to evaluate heterogeneity, egger's test was used to evaluate publication bias. RESULTS The analysis of 17 studies included in this study suggests that PDT may be effective in achieving complete response (CR) [ES = 0.50, 95%CI: (0.33,0.66)], partial response (PR) [ES = 0.42, 95%CI: (0.27,0.56)], no response (NR) [ES = 0.19, 95%CI: (0.11,0.27)]in patients with oral leukoplakia. The recurrence rate was also evaluated [ES = 0.13, 95%CI: (0.08,0.18)]. Subgroup analysis showed that various factors such as light source, wavelength, medium, duration of application, clinical and pathological diagnosis classification influenced efficacy of PDT. The lesion areas of the leukoplakia after treatment were reduced by 1.97cm2 compared with those before treatment. CONCLUSION Our findings show that PDT is a viable treatment for oral leukoplakia. However, the effectiveness of the therapy may depend on several factors, as suggested by our subgroup analyses. (Registration no. CRD42023399848 in Prospero, 26/02/2023).
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Affiliation(s)
- Rui Zhang
- Department of General Stomatology, General Hospital of Ningxia Medical University, Yinchuan, 750004, China.
| | - Tong Gao
- Department of Prosthodontics, Affiliated Hospital of Yanan University, Shaanxi, 716000, China
| | - Dan Wang
- Department of Stomatology, Qingtongxia Hospital of Traditional Chinese Medicine, Ningxia, 751600, China
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Nayak DR, Balakrishnan R, Dalakoti P, Bhanu U, Nair S, Poojary K. KTP 532 Laser Assisted Surgery for Oral Cavity Malignancy-A Retrospective Study. Indian J Otolaryngol Head Neck Surg 2023; 75:416-419. [PMID: 37275071 PMCID: PMC10235248 DOI: 10.1007/s12070-022-03214-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 09/24/2022] [Indexed: 11/18/2022] Open
Abstract
Aims and Objective To determine the effectiveness of KTP 532 in surgically treating early and early advanced oral malignancy with no surgical reconstruction of primary site. Materials and methods It is a retrospective study of 67 cases operated between 2000 to 2013 including T1, T2 and Early T3 cases, approved by ethical committee. All the cases underwent Laser assisted excision of tumour with or without Neck Dissection or Adjuvant Radiotherapy. Age of the cases varied from 20 to 80 years with mean age of 49 years. 47 cases were males and 20 were females. 26 cases in the study had neck nodes clinically whereas 41 cases had N0 status. Neck dissection was done (SOND or MRND) in 61 cases. In 6 cases (N0) no neck dissection was done. Results 61 cases had no loco-regional residual disease on their last follow up. Six cases had loco-regional recurrence within 6 months and salvage surgery was done. The overall mean survival was 81 months (92, 82 and 71 months in Stage I, II,III respectively). 3 year disease free survival rate was 91% as calculated using Kaplan- Meier Scale. In all these cases tumour was excised with KTP 532 laser and no reconstruction was done. Wound was allowed to heal with secondary intention. Conclusion Laser assisted excision of oral malignancy is an alternative to conventional treatment with more precision, less morbidity, shorter hospital stay and better functional outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03214-x.
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Affiliation(s)
- Dipak Ranjan Nayak
- Former Professor and Head of Department, Dept of Otorhinolaryngology- Head and Neck Surgery, Kasturba Medical College, Manipal, India
| | - R. Balakrishnan
- Professor , Dept of Otorhinolaryngology- Head and Neck Surgery, Kasturba Medical College, Manipal, India
| | - Pooja Dalakoti
- Assistant Professor, Dept of Otorhinolaryngology- Head and Neck Surgery, Government Medical College, Haldwani, India
| | - Uday Bhanu
- Former Junior Resident, Dept of Otorhinolaryngology- Head and Neck Surgery, Kasturba Medical College, Manipal, India
| | - Suraj Nair
- Former Junior Resident, Dept of Otorhinolaryngology- Head and Neck Surgery, Kasturba Medical College, Manipal, India
| | - Kailesh Poojary
- Professor , Dept of Otorhinolaryngology- Head and Neck Surgery, Kasturba Medical College, Manipal, India
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Xiong K, Wei F, Chen Y, Ji L, Chao H. Recent Progress in Photodynamic Immunotherapy with Metal-Based Photosensitizers. SMALL METHODS 2023; 7:e2201403. [PMID: 36549671 DOI: 10.1002/smtd.202201403] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/23/2022] [Indexed: 05/17/2023]
Abstract
Cancer ranks as a leading cause of death. There is an urgent need to develop minimally invasive methods to eradicate tumors and prevent their recurrence. As a light-driven modality, photodynamic therapy takes advantage of high tumor selectivity and low normal tissue damage. However, it shows poor potential for preventing tumor recurrence. Immunotherapy is currently being used as an alternative treatment for the control of malignant diseases. Although immunotherapy can establish long-time immune memory and efficiently protects treated patients from cancer relapse, its clinical efficacy is limited by the minority of patients' responding rate. Recently, photodynamic immunotherapy, which utilizes photosensitizers as an immunotherapy trigger to exert synergistic effects of photodynamic therapy and tumor immunotherapy, has attracted considerable interest. Like all the newly proposed treatments, there is still room for improvement. In this mini review, the progress in photodynamic immunotherapy with metal-based photosensitizers is summarized. It is hoped that this review can give a broad update on photodynamic immunotherapy and inspire readers.
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Affiliation(s)
- Kai Xiong
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, Guangdong Provincial Key Laboratory of Digestive Cancer Research, The Seventh Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510006, P. R. China
| | - Fangmian Wei
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, Guangdong Provincial Key Laboratory of Digestive Cancer Research, The Seventh Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510006, P. R. China
| | - Yu Chen
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, Guangdong Provincial Key Laboratory of Digestive Cancer Research, The Seventh Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510006, P. R. China
| | - Liangnian Ji
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, Guangdong Provincial Key Laboratory of Digestive Cancer Research, The Seventh Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510006, P. R. China
| | - Hui Chao
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, Guangdong Provincial Key Laboratory of Digestive Cancer Research, The Seventh Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510006, P. R. China
- MOE Key Laboratory of Theoretical Organic Chemistry and Functional Molecule, School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, 400201, P. R. China
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Tan YQ, Li ZT, Zhou G. Developmental synergism in the management of oral potentially malignant disorders. Photodiagnosis Photodyn Ther 2023; 42:103563. [PMID: 37031901 DOI: 10.1016/j.pdpdt.2023.103563] [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: 09/28/2022] [Revised: 03/21/2023] [Accepted: 04/07/2023] [Indexed: 04/11/2023]
Abstract
Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the oral cavity or lips. The unifying theme of OPMDs is their potential risk for cancer development. Therefore, the primary objective of the management should be to prevent carcinogenesis. Beyond diagnosis, current strategies for the management of OPMDs predominantly include non-surgical and surgical interventions and a "watch-and-see" approach, such as disease monitoring or surveillance, and preventive strategies. Though no optimal clinical treatment has gained universal approval for reducing or preventing malignant development of OPMDs. Therefore, an urgent need exits for improved treatment properties and effective predictive markers for OPMDs treatment. This review aims to outline recent synergism regarding to the management of OPMDs. Developing new technologies and improved application parameters to promote the treatment efficacy and a novel management prescription approach to OPMDs are proposed.
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Affiliation(s)
- Ya-Qin Tan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei- MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Zheng-Tao Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei- MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Gang Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei- MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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12
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Chiang TE, Lin YC, Wu CT, Wu ST, Chen YW. Association between socioeconomic status and severity of oral epithelial dysplasia using a Taiwanese Nationwide Oral Mucosal Screening Program: a retrospective analysis. BMC Oral Health 2022; 22:56. [PMID: 35246076 PMCID: PMC8895639 DOI: 10.1186/s12903-022-02084-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background The study aimed to investigate the association between socioeconomic status and severity of oral epithelial dysplasia (OED) using current data from the Taiwanese Nationwide Oral Mucosal Screening Program (TNOMSP).
Methods This retrospective analysis was conducted in the Department of Oral and Maxillofacial Surgery at a general hospital in Taipei, Taiwan. A total of 134 participants were analysed from a previous study database of 150 patients. The inclusion criteria included age > 20 years and a history of either tobacco or betel nut use. Background information, including para-habits such as betel and tobacco use, was analysed using the Pearson chi-square (χ2) test; furthermore, the correlation of background information with OED severity was investigated using logistic regression (mild or moderate/severe). Results High school education level (P < 0.001), poor self-awareness (P = 0.002), current betel use (P < 0.001), and tobacco use (P = 0.003) were highly correlated with moderate- and severe OED (P < 0.05). The odds ratio (OR) of education status above senior high school was 0.03 (95% confidence interval [CI] 0.01–0.15, P < 0.001), while that of junior high school was 1. Current betel chewing (OR 6.57 [95% CI 1.17–37.0], P = 0.033) was significantly associated with OED severity compared with never or ex-use of betel. Conclusions We found a strong correlation between the severity of OED and current betel use and low education status. The current study revealed that the socioeconomic status, poor self-awareness, and para-habit history of the patients with OED should be evaluated to identify high-risk individuals using TNOMSP.
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Affiliation(s)
- Tien-En Chiang
- Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, No. 325, Cheng-Kung Rd., Sec. 2, Neihu District, Taipei City, 11490, Taiwan, ROC.,School of Dentistry, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 11490, Taiwan, ROC
| | - Yu-Chun Lin
- Department of Pathology, Tri-Service General Hospital, No. 325, Sec. 2, Chenggong Rd., Neihu District, Taipei City, 11490, Taiwan, ROC
| | - Chi-Tsung Wu
- Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, No. 325, Cheng-Kung Rd., Sec. 2, Neihu District, Taipei City, 11490, Taiwan, ROC.,School of Dentistry, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 11490, Taiwan, ROC
| | - Sheng-Tang Wu
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 11490, Taiwan, ROC
| | - Yuan-Wu Chen
- Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, No. 325, Cheng-Kung Rd., Sec. 2, Neihu District, Taipei City, 11490, Taiwan, ROC. .,School of Dentistry, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 11490, Taiwan, ROC.
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13
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Kubrak T, Karakuła M, Czop M, Kawczyk-Krupka A, Aebisher D. Advances in Management of Bladder Cancer-The Role of Photodynamic Therapy. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27030731. [PMID: 35163996 PMCID: PMC8838614 DOI: 10.3390/molecules27030731] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/15/2022] [Accepted: 01/20/2022] [Indexed: 12/27/2022]
Abstract
Photodynamic therapy (PDT) is a non-invasive and modern form of therapy. It is used in the treatment of non-oncological diseases and more and more often in the treatment of various types of neoplasms in various locations including bladder cancer. The PDT method consists of local or systemic application of a photosensitizer, i.e., a photosensitive compound that accumulates in pathological tissue. Light of appropriate wavelength is absorbed by the photosensitizer molecules, which in turn transfers energy to oxygen or initiates radical processes that leads to selective destruction of diseased cells. The technique enables the selective destruction of malignant cells, as the photocytotoxicity reactions induced by the photosensitizer take place strictly within the pathological tissue. PDT is known to be well tolerated in a clinical setting in patients. In cited papers herein no new safety issues were identified. The development of anti-cancer PDT therapies has greatly accelerated over the last decade. There was no evidence of increased or cumulative toxic effects with each PDT treatment. Many modifications have been made to enhance the effects. Clinically, bladder cancer remains one of the deadliest urological diseases of the urinary system. The subject of this review is the anti-cancer use of PDT, its benefits and possible modifications that may lead to more effective treatments for bladder cancer. Bladder cancer, if localized, would seem to be a good candidate for PDT therapy since this does not involve the toxicity of systemic chemotherapy and can spare normal tissues from damage if properly carried out. It is clear that PDT deserves more investment in clinical research, especially for plant-based photosensitizers. Natural PS isolated from plants and other biological sources can be considered a green approach to PDT in cancer therapy. Currently, PDT is widely used in the treatment of skin cancer, but numerous studies show the advantages of related therapeutic strategies that can help eliminate various types of cancer, including bladder cancer. PDT for bladder cancer in which photosensitizer is locally activated and generates cytotoxic reactive oxygen species and causing cell death, is a modern treatment. Moreover, PDT is an innovative technique in oncologic urology.
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Affiliation(s)
- Tomasz Kubrak
- Department of Biochemistry and General Chemistry, Medical College of the University of Rzeszów, 35-310 Rzeszów, Poland
- Correspondence:
| | - Michał Karakuła
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland;
| | - Marcin Czop
- Department of Clinical Genetics, Medical University of Lublin, Radziwiłłowska 11, 20-080 Lublin, Poland;
| | - Aleksandra Kawczyk-Krupka
- School of Medicine with the Division of Dentistry in Zabrze, Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Batorego Street 15, 41-902 Bytom, Poland;
| | - David Aebisher
- Department of Photomedicine and Physical Chemistry, Medical College of the University of Rzeszów, 35-310 Rzeszów, Poland;
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Binnal DA, Tadakamadla DJ, Rajesh DG, Tadakamadla DSK. Photodynamic therapy for oral potentially malignant disorders: A Systematic Review and Meta-analysis. Photodiagnosis Photodyn Ther 2022; 37:102713. [PMID: 34999271 DOI: 10.1016/j.pdpdt.2022.102713] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/29/2021] [Accepted: 01/03/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of Photodynamic Therapy (PDT) in the treatment of Oral Potentially Malignant Disorders (OPMDs) patients. METHODOLOGY An electronic search was conducted to retrieve articles published until September 2021. Meta-analyses were conducted for the outcomes of complete response (CR) and any response (AR) after treatment with PDT using data from single-arm studies, case series and non-randomised controlled trials (NRCTs). RESULTS In total, 49 articles were included. RCTs revealed insignificant mean difference (MD) in efficacy index between PDT and comparison groups (MD: 1.32; 95% CI:-28.10-30.72, p=0.930). The likelihood of CR (OR:0.84; 95% CI: 0.42-1.71, p=0.637) or AR (OR:2.10; 95% CI: 0.31-14.25, p=0.448) was not different in PDT group when compared with any comparison treatments in NRCTs. CR/AR among single arm studies was 60.6% (95% CI: 50.5-70.7, P<0.001) and 93.7% (95% CI:91.5-95.8, P<0.001) respectively. Higher prevalence of CR and AR was observed for dysplasia or carcinoma insitu (CIS) (CR: 81%, 95% CI: 70.8-91.3, P<0.001; AR: 94.3%; 95% CI: 89-99.6, P<0.001) and actinic cheilitis (AC) (CR: 73.9%, 95% CI: 65.9-81.9, P<0.001; AR:97%; 95% CI:94.9-99, P<0.001). CONCLUSIONS More than half of the patients receiving PDT showed CR, with more than 90% responding to the treatment. PDT was most effective on oral dysplasias, followed by AC.
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Affiliation(s)
- Dr Almas Binnal
- Associate Professor, Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Mangalore - 575001, Manipal Academy of Higher Education, Manipal, Karnataka, India-576104.
| | | | - Dr Gururaghavendran Rajesh
- Professor and Head, Department of Public Health Dentistry, Manipal College of Dental Sciences, Mangalore - 575001, Manipal Academy of Higher Education, Manipal, Karnataka, India-576104.
| | - Dr Santosh Kumar Tadakamadla
- Senior Research Fellow, National Health and Medical Research Council Early Career Fellow, School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Australia.
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15
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Erira AT, Navarro AFR, Robayo DAG. Human papillomavirus, Epstein-Barr virus, and Candida albicans co-infection in oral leukoplakia with different degrees of dysplasia. Clin Exp Dent Res 2021; 7:914-923. [PMID: 34101999 PMCID: PMC8543472 DOI: 10.1002/cre2.435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To identify human papillomavirus (HPV), Epstein-Barr virus (EBV), and Candida albicans in oral leukoplakia with different degrees of dysplasia. MATERIALS AND METHODS An observational, cross-sectional, descriptive study was performed using 30 formalin-fixed and paraffin-embedded tissues from patients with clinical suspicion of leukoplakia and confirmed diagnosis of oral dysplasia. Histological analyses were performed by two pathologists (interobserver) and dysplasias were classified as mild, moderate, or severe. Conventional PCR was used to detect HPV and EBV viruses and C. albicans. To determine the association between each microorganism with different degrees of dysplasia a Chi-square test was employed. RESULTS The tongue was the most common site for leukoplakias (71.4%) in females with a mean age of 50 years (ranging between 30 to 50 years old; 57.1%). EBV was the most frequently detected (73.3%), followed by HPV (43.3%), mainly of type 16 (40%), and C. albicans (23.3%). Significant differences were observed between degrees of dysplasia and HPV presence (p = 0.005). In lesions positive for HPV, EBV, and C. albicans the most frequent histological changes were hyperkeratosis, irregular interpapillary ridges, and loss of basal stratum cell polarity. CONCLUSION Co-infection with human papillomavirus, Epstein Barr virus, and Candida albicans in oral leukoplakia could be associated with dysplastic changes.
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Affiliation(s)
- Alveiro T Erira
- Facultad de Odontología, Universidad Cooperativa de Colombia, Bogotá, Colombia
| | | | - Dabeiba Adriana García Robayo
- Centro de Investigaciones Odontológicas - Facultad de Odontología, Pontificia Universidad Javeriana, Bogotá, Colombia
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Chen Q, Dan H, Pan W, Jiang L, Zhou Y, Luo X, Zeng X. Management of oral leukoplakia: a position paper of the Society of Oral Medicine, Chinese Stomatological Association. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:32-43. [PMID: 34006487 DOI: 10.1016/j.oooo.2021.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The objective of this study was to develop the first edition of a Chinese evidence-based position paper on the management of oral leukoplakia (OLK). STUDY DESIGN The consultant group for drafting the position paper consisted of 31 oral medicine specialists and 2 evidence-based medicine specialists. English studies (searched in PubMed, EMBASE, and the Cochrane Library) and Chinese studies (searched in China National Knowledge Infrastructure and WanFang) published before January 2018 were used. The quality of the study was assessed using the Grading of Recommendations Assessment, Development, and Evaluation grid, and the strength of the recommendations was determined based on the results of 3 rounds of voting among the consultant group members using the Delphi method. RESULTS Twenty-two evidence-based guidelines for clinical management and monitoring of OLK were established in this position paper. A clinical path diagram for oral health practitioners was constructed based on the recommendations. CONCLUSION Current evidence suggests that management and monitoring of patients with OLK should be performed by experienced clinicians to control the lesion and for early detection of malignant transformation. However, all recommendations are based on evidence of low or extremely low quality and may require further modification as new evidence is produced.
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Affiliation(s)
- Qianming Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Weiyi Pan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lu Jiang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xiaobo Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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17
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Romano A, Di Stasio D, Gentile E, Petruzzi M, Serpico R, Lucchese A. The potential role of Photodynamic therapy in oral premalignant and malignant lesions: A systematic review. J Oral Pathol Med 2021; 50:333-344. [PMID: 33217059 DOI: 10.1111/jop.13139] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is considered as a valid treatment option in various branches of dentistry. This systematic review aims to evaluate the usefulness of PDT for treatment of oral premalignant and malignant lesions. METHODS The MeSH terms "Photodynamic therapy" and "PDT," in combination with other terms, have been searched by three search engines (PubMed, ISI Web of Science, and the Cochrane Library), and a systematic review has been performed. The Population, Intervention, Comparison, Outcomes, and Study design (PICOS) has been applied as method to outline our study eligibility criteria. Risk of Bias in Non-randomized Studies of Intervention (ROBINS-I) has been performed too. RESULTS Initial results were 1513. Definitely, 27 studies met our selection criteria. CONCLUSIONS Topical PDT is an easy to perform technique, well-tolerated treatment and it appears to be an effective method with encouraging achievements in the treatment of premalignant and malignant lesions of the soft tissues of the oral cavity; nevertheless more studies are required to integrate the up-to-date experience of this application.
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Affiliation(s)
- Antonio Romano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Enrica Gentile
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, University of Bari "A. Moro", Bari, Italy
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Photodynamic therapy using topical toluidine blue for the treatment of oral leukoplakia: A prospective case series. Photodiagnosis Photodyn Ther 2020; 31:101888. [PMID: 32593778 DOI: 10.1016/j.pdpdt.2020.101888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Photodynamic therapy (PDT) is a minimally invasive method for the treatment of oral leukoplakia (OL) through the activation of a photosensitizer, after exposure to a specific wavelength light source. METHODS To investigate the effectiveness of toluidine blue as topical photosensitizer. Eleven patients participated in this study; fifteen oral leukoplakia lesions were treated, in several sessions, with 2.5 % toluidine blue and an LED source of 630 nm wavelength. Patients were evaluated at baseline (t0), at the end of treatment cycles (t1) and one year from the end of treatment (t2). All the treated sites were photographed at each visit. Images were processed with ImageJ 1.52 software in order to obtain the areas (mm2) of the treated lesions. Comparison between data at different follow-up was performed using a paired T-test. RESULTS At t1, complete response was obtained in six lesions, partial response in seven lesions while only two lesions showed no response. At t2, a further improvement was observed in two patients. The analysis of the areas showed significant reduction of the lesion size from t0 to t1 (p = 0.003), and from t1 to t2 (p = 0.01). CONCLUSION Toluidine blue appears to be a promising photosensitizer in the photodynamic therapy of oral leukoplakia.
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Kawczyk-Krupka A, Bartusik-Aebisher D, Latos W, Cieślar G, Sieroń K, Kwiatek S, Oleś P, Kwiatek B, Aebisher D, Krupka M, Wiench R, Skaba D, Olek M, Kasperski J, Czuba Z, Sieroń A. Clinical Trials and Basic Research in Photodynamic Diagnostics and Therapies from the Center for Laser Diagnostics and Therapy in Poland. Photochem Photobiol 2020; 96:539-549. [PMID: 32112419 DOI: 10.1111/php.13243] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/09/2020] [Indexed: 12/29/2022]
Abstract
The purpose of this review is to present an overview of the development of photodiagnostic and photodynamic therapy (PDD and PDT) techniques in Poland. The paper discusses the principles of PDD, including fluorescent techniques in determining precancerous conditions and cancers of the skin, digestive tract, bladder and respiratory tract. Methods of PDT of cancer will be discussed and the current state of knowledge as well as future trends in the development of photodynamic techniques will be presented, including the possibility of using photodynamic antimicrobial therapy. Research pioneers in photodynamic medicine such as Thomas Dougherty are an inspiration for the development of methods of PDD and PDT in our Clinic. The Center for Laser Diagnostics and Therapy in Bytom, Poland, promotes the propagation of PDD and PDT through the training of clinicians and raising awareness among students in training and the general public. Physicians at the Center are engaged in photomedical research aimed at clinical implementation and exploration of new avenues in photomedicine while optimizing existing modalities. The Center promotes dissemination of clinical results from a wide range of topics in PDD and PDT and serving as representative authorities of photodynamic medicine in Poland and Europe.
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Affiliation(s)
- Aleksandra Kawczyk-Krupka
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | | | - Wojciech Latos
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Grzegorz Cieślar
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Karolina Sieroń
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland.,Department of Physical Medicine, Chair of Physiotherapy, Medical University of Silesia, Katowice, Poland
| | - Sebastian Kwiatek
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Piotr Oleś
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Beata Kwiatek
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - David Aebisher
- Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Magdalena Krupka
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland
| | - Rafał Wiench
- Department of Periodontal Diseases and Oral Mucosa Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Dariusz Skaba
- Department of Periodontal Diseases and Oral Mucosa Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Marcin Olek
- Department of Prosthetic Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Jacek Kasperski
- Department of Prosthetic Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Zenon Czuba
- Department of Microbiology and Immunology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Aleksander Sieroń
- Department of Internal Medicine, Angiology, and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Bytom, Poland.,Department of Physiotherapy, Jan Dlugosz University in Częstochowa, Częstochowa, Poland
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20
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Jin X, Xu H, Deng J, Dan H, Ji P, Chen Q, Zeng X. Photodynamic therapy for oral potentially malignant disorders. Photodiagnosis Photodyn Ther 2019; 28:146-152. [PMID: 31394296 DOI: 10.1016/j.pdpdt.2019.08.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 06/30/2019] [Accepted: 08/02/2019] [Indexed: 02/05/2023]
Abstract
To assess the impact of photodynamic therapy (PDT) parameters in the management of oral potentially malignant disorders (OPMDs). We conducted a systematic review and meta-analysis of studies that assessed the curative effect of PDT published in PubMed and Embase until Dec 2018. Random or fixed effects models for pooled estimates calculation were used. A pooled estimate calculation revealed that lesion size decreased by 1.38 cm2 (95% CI: 0.39-2.36) after PDT, and the overall complete response (CR) was 0.52 (95% CI: 0.36-0.68), while partial response (PR) reached 0.82 (95% CI: 0.74-0.88). Subgroup analyses revealed that the lesion response (CR: 0.21 [95% CI: 0.12-0.33]) of oral lichen planus was worse than that of other disease entities. 20% aminolevulinic acid was more effective than other photosensitizers, with the overall CR was 0.68 (95% CI: 0.42-0.86), while the PR was 0.88 (95% CI: 0.76-0.94). Topical use of photosensitizers can yield desirable results, while gargling methylene blue yields poor response (0.82 [95% CI: 0.75-0.88] vs. 0.59 [95% CI: 0.44-0.72], respectively). PDT is an effective treatment modality in the management of OPMDs, the overall efficacy of which is influenced by several factors.
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Affiliation(s)
- Xin Jin
- College of Stomatology, Chongqing Medical University, Chongqing 401147, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China
| | - Hao Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jing Deng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ping Ji
- College of Stomatology, Chongqing Medical University, Chongqing 401147, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
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Farah CS, Koelmeyer N, Kaney A, Simanovic B. Nitrous oxide cryotherapy for the management of benign lesions of the oral cavity. J Oral Pathol Med 2019; 48:611-618. [DOI: 10.1111/jop.12912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/07/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Camile S. Farah
- UWA Dental School University of Western Australia Nedlands Western Australia Australia
- Australian Centre for Oral Oncology Research & Education Nedlands Western Australia Australia
| | - Natasha Koelmeyer
- UWA Dental School University of Western Australia Nedlands Western Australia Australia
| | - Anjuli Kaney
- UWA Dental School University of Western Australia Nedlands Western Australia Australia
| | - Borjana Simanovic
- Australian Centre for Oral Oncology Research & Education Nedlands Western Australia Australia
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Han Y, Xu S, Jin J, Wang X, Liu X, Hua H, Wang X, Liu H. Primary Clinical Evaluation of Photodynamic Therapy With Oral Leukoplakia in Chinese Patients. Front Physiol 2019; 9:1911. [PMID: 30723421 PMCID: PMC6350274 DOI: 10.3389/fphys.2018.01911] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 12/18/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Photodynamic therapy (PDT) has demonstrated promising results in the treatment of oral leukoplakia. This study evaluated the clinical efficacy and side effects of PDT in the treatment of Chinese patients with oral leukoplakia. Methods: Twenty-nine patients with oral leukoplakia were enrolled in this study, including patients with both homogenous and non-homogenous lesions and various dysplastic tissues. All patients received PDT using a 632 nm laser at 500 mW/cm2 power density at a dosage of 90–180 J/cm2 and with aminolevulinic acid (ALA) used as a photosensitizer. A fixing and restricting complex as well as high laser power density for PDT in oral cavity was applied. Results: An overall response rate of 86.2% was achieved in this study, including 55.2% complete remission and 31.0% partial remission. The only adverse events observed in subjects were transient local ulcer and pain. It is observed the PDT utilizing ALA showed strong effectiveness in patients with moderate to severe dysplasia, as less treatment time per cm2 of lesion is required. Conclusion: Topic ALA-PDT is effective to treat oral leukoplakia, especially for that with the presence of dysplasia. A fixing and restricting complex as well as high laser power density for PDT in oral cavity should be considered as an optimal choice.
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Affiliation(s)
- Ying Han
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
| | - Si Xu
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
| | - Jianqiu Jin
- National Center of Gerontology, Beijing Hospital, Beijing, China
| | - Xing Wang
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
| | - Xiaodan Liu
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
| | - Hong Hua
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
| | - Xiaoyang Wang
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Hongwei Liu
- Department of Oral Medicine, Peking University School of Stomatology, Beijing, China
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Farah CS, Pollaers K, Frydrych A. Management of Premalignant Disease of the Oral Mucosa. HEAD AND NECK CANCER CLINICS 2019. [DOI: 10.1007/978-981-13-2931-9_11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Photodynamic therapy in the treatment of oral leukoplakia: A systematic review. Photodiagnosis Photodyn Ther 2018; 25:17-22. [PMID: 30391342 DOI: 10.1016/j.pdpdt.2018.10.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 09/03/2018] [Accepted: 10/29/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of the present study was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral leukoplakia (OLK). METHODS This systematic review aimed to address the following focused question: "Is photodynamic therapy effective in the management of oral leukoplakia?'' PubMed/Medline, EMBASE, ISI Web of Knowledge, OVID, CNKI, and WANFANG DATA were searched up to and including June 2018 using different combinations of the following keywords: photodynamic therapy, leukoplakia, oral dysplasia, oral precancers, and oral premalignant lesions. RESULTS Sixteen studies were included in the present study. A total of 352 patients was included in this review, with age ranging from 20 to 79 years. Photosensitizers used were aminolevulinic acid, Photofrin, methylene blue, and chlorine-e6. Laser wavelength, duration of irradiation, and power density were 420-660 nm, 60-1000 s, and 100-150 mW/cm2, respectively. On the whole, the rates of complete response and partial response were 32.9% and 43.2%, and the sum was 76.1%. The follow-up period ranged from 1 month to 119 months. The recurrence rate of OLK was 0-60%. CONCLUSION PDT appears to be a useful therapeutic strategy in the management of oral leukoplakia as a non-surgical treatment. Further RCTs with long follow-up period, standardized PDT parameters, and comparing efficacy of PDT with various other therapies are needed to acquire definite conclusions.
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Photodynamic therapy as an alternative to antibiotic therapy for the treatment of infected leg ulcers. Photodiagnosis Photodyn Ther 2018; 23:132-143. [DOI: 10.1016/j.pdpdt.2018.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 03/25/2018] [Accepted: 05/02/2018] [Indexed: 12/29/2022]
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Lesion oxygenation associates with clinical outcomes in premalignant and early stage head and neck tumors treated on a phase 1 trial of photodynamic therapy. Photodiagnosis Photodyn Ther 2017; 21:28-35. [PMID: 29113960 DOI: 10.1016/j.pdpdt.2017.10.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/06/2017] [Accepted: 10/19/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND We report on a Phase 1 trial of photodynamic therapy (PDT) for superficial head and neck (H&N) lesions. Due to known oxygen dependencies of PDT, translational measurements of lesion hemoglobin oxygen saturation (StO2) and blood volume (tHb) were studied for associations with patient outcomes. METHODS PDT with aminolevulinc acid (ALA) and escalating light doses was evaluated for high-grade dysplasia, carcinoma-in-situ, and microinvasive carcinomas of the H&N. Among 29 evaluable patients, most (18) had lesions of the tongue or floor of mouth (FOM). Disease was intact in 18 patients and present at surgical margins in 11 patients. In 26 patients, lesion StO2 and tHb was measured. RESULTS Local control (LC) at 24 months was 57.5% among all patients. In patients with tongue/FOM lesions LC was 42.7%, and it was 50.1% for those with intact lesions. Lesion tHb was not associated with 3-month complete response (CR), but StO2 was higher in patients with CR. In tongue/FOM lesions, baseline StO2 [mean(SE)] was 54(4)% in patients (n=12) with CR versus 23(8)% in patients (n=6) with local recurrence/persistence (p=0.01). Similarly, for intact disease, baseline StO2 was 54(3)% in patients (n=10) with CR versus 28(8)% in patients (n=5) without CR (p=0.03). In patients with intact disease, higher baseline StO2 associated with 24-month local control (p=0.02). CONCLUSIONS Measurement of the physiologic properties of target lesions may allow for identification of patients with the highest probability of benefiting from PDT. This provides opportunity for optimizing light delivery based on lesion characteristics and/or informing ongoing clinical decision-making in patients who would most benefit from PDT.
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Abstract
Oral potentially malignant disorders (OPMDs) refer to epithelial lesions and conditions with an increased risk for malignant transformation; oral leukoplakia is the most commonly encountered. Overall, OPMDs have a low risk for malignant transformation, yet the challenge is the difficulty to reliably identify and predict which patients with OPMDs are at the highest risk for malignant transformation. Future research is needed to elucidate the molecular aspects of OPMDs, to improve current diagnostic strategies, leading to personalized management.
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Quintanilha NP, dos Santos Miranda Costa I, Freiman de Souza Ramos M, Campos de Oliveira Miguel N, Riemma Pierre MB. α-Bisabolol improves 5-aminolevulinic acid retention in buccal tissues: Potential application in the photodynamic therapy of oral cancer. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 174:298-305. [DOI: 10.1016/j.jphotobiol.2017.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/13/2017] [Accepted: 08/07/2017] [Indexed: 11/29/2022]
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Natekar M, Raghuveer HP, Rayapati DK, Shobha ES, Prashanth NT, Rangan V, Panicker AG. A comparative evaluation: Oral leukoplakia surgical management using diode laser, CO2 laser, and cryosurgery. J Clin Exp Dent 2017. [PMID: 28638555 PMCID: PMC5474334 DOI: 10.4317/jced.53602] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The comparatively evaluate the three surgical treatment modalities namely cryosurgery, diode and CO2 laser surgery in terms of healing outcomes on the day of surgery, first and second week post operatively and recurrence at the end of 18 months was assessed. Material and Methods Thirty selected patients were divided randomly into three groups. Each group comprising of ten patients were subjected to one of the three modalities of treatment namely cryosurgery, diode laser or CO2 laser surgery for ablation of OL. Obtained data was analyzed using mainly using Chi-square and Anova tests. Results Study showed statistical significant differences (p > 0.05) for evaluation parameters like pain, edema and scar. The parameters like infection, recurrence, bleeding showed no statistical significance. Pain was significantly higher in CO2 laser surgery group as compared with diode laser group. There was no recurrence observed at the end of the 6 months follow up period in all the three study groups. Conclusions Observations from the study highlights that all three surgical modalities used in this study were effective for treatment of OL, and the overall summation of the results of the study showed that laser therapy (CO2 and Diode) seems to offer better clinically significant results than cryotherapy. Key words:Oral premalignant lesion, leukoplakia, cryosurgery, CO2 laser surgery, diode laser surgery.
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Affiliation(s)
- Madhukar Natekar
- Post Graduate Student , Department of Oral and Maxillofacial Surgery, Dayananda Sagar College of Dental Sciences
| | | | - Dilip-Kumar Rayapati
- MDS,Professor, Department of Oral and Maxillofacial Surgery, Dayananda Sagar College of Dental Sciences
| | - Eshwara-Singh Shobha
- MDS,Professor, Department of Oral and Maxillofacial Surgery, Dayananda Sagar College of Dental Sciences
| | - Nagesh-Tavane Prashanth
- MDS, Associate Professor, Department of Oral and Maxillofacial Surgery, Dayananda Sagar College of Dental Sciences
| | - Vinod Rangan
- MDS, Assistant Professor, Department of Oral and Maxillofacial Surgery, Dayananda Sagar College of Dental Sciences
| | - Archana G Panicker
- Post Graduate Student , Department of Oral and Maxillofacial Surgery, Dayananda Sagar College of Dental Sciences
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Gondivkar SM, Gadbail AR, Choudhary MG, Vedpathak PR, Likhitkar MS. Photodynamic treatment outcomes of potentially-malignant lesions and malignancies of the head and neck region: A systematic review. ACTA ACUST UNITED AC 2017; 9. [PMID: 28480637 DOI: 10.1111/jicd.12270] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 02/28/2017] [Indexed: 01/19/2023]
Abstract
AIM The aim of the present study was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral potentially-malignant disorders (PMDS) and head and neck squamous cell carcinoma (HNSCC). METHODS From 1985 to 2015, PubMed/Medline, Google Scholar, EMBASE, and ISI Web of Knowledge were searched using different combinations of the following key words: PDT, oral precancer, leukoplakia, erythroplakia, erythroleukoplakia, verrucous hyperplasia, oral submucous fibrosis, and HNSCC. Review articles, experimental studies, case reports, commentaries, letters to the editor, unpublished articles, and articles published in languages other than English were excluded. RESULTS Twenty-six studies were included in the present study. The number of patients ranged from 2 to 147, with a mean age of 50-67 years. The reported numbers of PMDS and HNSCC ranged between 5 and 225. Photosensitizers used were aminolevulinic acid, meta-tetrahydroxyphenylchlorin, Foscan, hematoporphyrin derivatives, Photofrin, Photosan, and chlorine-e6. Laser wavelength, power density, irradiation duration were 585-652 nm, 50-500 mW/cm2 , and 1-143 minutes, respectively. Complete, partial, and no response to PDT was found in 22.58%-100%, 4%-66%, and 0%-38.70% of PMDS, respectively, and 16%-100% of complete response in HNSCC patients. CONCLUSION PDT is effective in the management of PMDS and HNSCC.
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Affiliation(s)
- Shailesh M Gondivkar
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Amol Ramchandra Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India
| | - Manjari G Choudhary
- Department of Oral Medicine and Radiology, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hirey Dental College and Hospital, Nashik, Maharashtra, India
| | - Priyanka R Vedpathak
- Department of Oral Medicine and Radiology, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hirey Dental College and Hospital, Nashik, Maharashtra, India
| | - Manoj S Likhitkar
- Department of Conservative and Endodontics, HSRS Dental College and Hospital, Hingoli, Maharashtra, India
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Naurecka ML, Sierakowski BM, Kasprzycka W, Dojs A, Dojs M, Suszyński Z, Kwaśny M. FTIR-ATR and FT-Raman Spectroscopy for Biochemical Changes in Oral Tissue. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ajac.2017.83015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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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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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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Peng Q, Wang Y, Quan H, Li Y, Tang Z. Oral verrucous carcinoma: From multifactorial etiology to diverse treatment regimens (Review). Int J Oncol 2016; 49:59-73. [PMID: 27121637 DOI: 10.3892/ijo.2016.3501] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 03/28/2016] [Indexed: 11/05/2022] Open
Abstract
Oral verrucous carcinoma (OVC) is a verrucous variant of oral squamous cell carcinoma (OSCC), which accounts for 2-12% of all oral carcinomas with a 5-year survival rate of only approximately 50%. Enormous effort has been dedicated to this cancer, and the past decades have witnessed significant advances in relevant diagnostic and therapeutic approaches. Currently, there exist three challenges from primary sub-fields of research and clinical practice of the cancer, namely multifactorial etiology, complex molecular mechanism, and deficient treatment. This study reviews the existing literature on the cancer, encompassing its etiology, clinical manifestations and pathology, molecular mechanism, diagnosis and differential diagnosis, and treatment. For improved treatment of OVC, multifactorial etiology analysis, incorporation of effective biomarkers for mechanism illustration, and integration of multidisciplinary modalities are expounded, in an attempt to resolve the challenges and to provide a useful guide for future research in the field.
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Affiliation(s)
- Qian Peng
- Xiangya Stomatological Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Yuehong Wang
- Xiangya Stomatological Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Hongzhi Quan
- Xiangya Stomatological Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Yiping Li
- Xiangya Stomatological Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Zhangui Tang
- Xiangya Stomatological Hospital, Central South University, Changsha, Hunan 410008, P.R. China
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de Bruijn HS, Brooks S, van der Ploeg-van den Heuvel A, ten Hagen TLM, de Haas ERM, Robinson DJ. Light Fractionation Significantly Increases the Efficacy of Photodynamic Therapy Using BF-200 ALA in Normal Mouse Skin. PLoS One 2016; 11:e0148850. [PMID: 26872051 PMCID: PMC4752243 DOI: 10.1371/journal.pone.0148850] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/25/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Light fractionation significantly increases the efficacy of 5-aminolevulinic acid (ALA) based photodynamic therapy (PDT) using the nano-emulsion based gel formulation BF-200. PDT using BF-200 ALA has recently been clinically approved and is under investigation in several phase III trials for the treatment of actinic keratosis. This study is the first to compare BF-200 ALA with ALA in preclinical models. RESULTS In hairless mouse skin there is no difference in the temporal and spatial distribution of protoporphyrin IX determined by superficial imaging and fluorescence microscopy in frozen sections. In the skin-fold chamber model, BF-200 ALA leads to more PpIX fluorescence at depth in the skin compared to ALA suggesting an enhanced penetration of BF-200 ALA. Light fractionated PDT after BF-200 ALA application results in significantly more visual skin damage following PDT compared to a single illumination. Both ALA formulations show the same visual skin damage, rate of photobleaching and change in vascular volume immediately after PDT. Fluorescence immunohistochemical imaging shows loss of VE-cadherin in the vasculature at day 1 post PDT which is greater after BF-200 ALA compared to ALA and more profound after light fractionation compared to a single illumination. DISCUSSION The present study illustrates the clinical potential of light fractionated PDT using BF-200 ALA for enhancing PDT efficacy in (pre-) malignant skin conditions such as basal cell carcinoma and vulval intraepithelial neoplasia and its application in other lesion such as cervical intraepithelial neoplasia and oral squamous cell carcinoma where current approaches have limited efficacy.
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Affiliation(s)
- Henriëtte S. de Bruijn
- Center for Optical Diagnostics and Therapy, Department of Otolaryngology and Head & Neck Surgery, Erasmus MC, Rotterdam, The Netherlands
| | - Sander Brooks
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
| | | | | | | | - Dominic J. Robinson
- Center for Optical Diagnostics and Therapy, Department of Otolaryngology and Head & Neck Surgery, Erasmus MC, Rotterdam, The Netherlands
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Saini R, Poh CF. Photodynamic therapy: a review and its prospective role in the management of oral potentially malignant disorders. Oral Dis 2015; 19:440-51. [PMID: 24079944 DOI: 10.1111/odi.12003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 07/24/2012] [Accepted: 07/25/2012] [Indexed: 01/25/2023]
Abstract
With the unreliability of epithelial dysplasia as a predictor to determine the risk of future malignant development, subjectivity associated in evaluating dysplasia by pathologists and paucity of biomarkers that could accurately predict the progression risks in oral potentially malignant disorders (PMDs), eradication of the lesions appears to be the most desirable approach to minimize the risk of invasive cancer formation. Interventions, such as surgery and chemoprevention, have not shown promising long-term results in the treatment of these lesions, and lack of guidelines and general consensus on their management has incited much anxiety and doubts in both patients and community clinicians. Topical photodynamic therapy (PDT) is a minimally invasive and minimally toxic technique that in recent years has shown great promise in the management of PMDs. In this review, we describe the historical developments in the field of PDT, its basic mechanisms, as well as related clinical studies, and its challenges in the management of oral PMDs. Based on its high efficacy and low side effects, its high patient acceptance/compliance, the simplicity of the procedure and its minimal pretreatment preparation, topical PDT is believed to have potential to play an important role in the management of PMDs, especially of the low-grade dysplasia.
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Affiliation(s)
- R Saini
- Department of Integrative Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada; Faculty of Dentistry, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, BC, Canada
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Chen HM, Cheng SJ, Lin HP, Yu CH, Wu YC, Chiang CP. Cryogun cryotherapy for oral leukoplakia and adjacent melanosis lesions. J Oral Pathol Med 2015; 44:607-13. [PMID: 25367354 DOI: 10.1111/jop.12287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Our previous study has shown that cryogun cryotherapy is a good and effective treatment modality for oral leukoplakia. METHODS In this study, we used cryogun cryotherapy to treat 72 oral leukoplakia and adjacent smoking-induced melanosis (OLM) lesions on the buccal mucosae. RESULTS Of 72 OLM lesions, 14 had epithelial hyperplasia with parakeratosis, 24 had epithelial hyperplasia with hyperkeratosis, 26 had mild dysplasia, seven had moderate dysplasia, and one had severe dysplasia. Complete regression was achieved in all 72 OLM lesions after a mean of 3.3 ± 1.3 cryogun cryotherapy treatments. We found that OLM lesions in patients without smoking habit, with the greatest diameter < 2.8 cm, with epithelial dysplasia, or with a surface keratin thickness ≤ 50 μm needed significantly fewer mean number of cryogun cryotherapy treatment to achieve complete regression than those OLM lesions in patients with smoking habit, with the greatest diameter ≥ 2.8 cm, without epithelial dysplasia, or with a surface keratin thickness > 50 μm (all P-values < 0.001), respectively. Univariate logistic regression analyses showed that the greatest diameter, epithelial dysplasia, smoking habit, and surface keratin thickness were the factors influencing the cryogun cryotherapy treatment number (all P-values < 0.001). However, only the greatest diameter < 2.8 cm (P < 0.001) was an independent factor influencing the number of cryogun cryotherapy treatment required to achieve complete regression of the OLM lesion by multivariate logistic regression analyses. CONCLUSION Cryogun cryotherapy is an effective treatment modality for OLM lesions.
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Affiliation(s)
- Hsin-Ming Chen
- Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, National Taiwan University, Taipei, Taiwan
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shih-Jung Cheng
- Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hung-Pin Lin
- Department of Dentistry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chuan-Hang Yu
- Oral Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan
- Institute of Stomatology, Chung Shan Medical University, Taichung, Taiwan
| | - Yang-Che Wu
- Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chun-Pin Chiang
- Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, National Taiwan University, Taipei, Taiwan
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Yardimci G, Kutlubay Z, Engin B, Tuzun Y. Precancerous lesions of oral mucosa. World J Clin Cases 2014; 2:866-872. [PMID: 25516862 PMCID: PMC4266835 DOI: 10.12998/wjcc.v2.i12.866] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 08/28/2014] [Accepted: 09/24/2014] [Indexed: 02/05/2023] Open
Abstract
Precancerous lesions of oral mucosa, known as potentially malignant disorders in recent years, are consists of a group of diseases, which should be diagnosed in the early stage. Oral leukoplakia, oral submucous fibrosis, and oral erythroplakia are the most common oral mucosal diseases that have a very high malignant transformation rate. Oral lichen planus is one of the potentially malignant disorders that may be seen in six different subtypes including papular, reticular, plaque-like, atrophic, erosive, and bullous type, clinically. Atrophic and erosive subtypes have the greater increased malignant transformation risk compared to another subtypes. Although there are various etiological studies, the etiology of almost all these diseases is not fully understood. Geographically, etiologic factors may vary. The most frequently reported possible factors are tobacco use, alcohol drinking, chewing of betel quid containing areca nut, and solar rays. Early diagnosis is very important and can be lifesaving, because in late stages, they may be progressed to severe dysplasia and even carcinoma in situ and/or squamous cell carcinoma. For most diseases, treatment results are not satisfactory in spite of miscellaneous therapies. While at the forefront of surgical intervention, topical and systemic treatment alternatives such as corticosteroids, calcineurin inhibitors, and retinoids are widely used.
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Vohra F, Al-Kheraif AA, Qadri T, Hassan MIA, Ahmed A, Warnakulasuriya S, Javed F. Efficacy of photodynamic therapy in the management of oral premalignant lesions. A systematic review. Photodiagnosis Photodyn Ther 2014; 12:150-9. [PMID: 25315968 DOI: 10.1016/j.pdpdt.2014.10.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 09/26/2014] [Accepted: 10/01/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral premalignant lesions. METHODS The addressed focused question was "Is PDT effective in the management of oral premalignant lesions?" PubMed/Medline, Google-Scholar, EMBASE and ISI Web of Knowledge databases were searched from 1984 till June 2014 using different combinations of the following keywords: photodynamic therapy; oral premalignant lesions; leukoplakia; erythroplakia; erythro-leukoplakia; verrucous hyperplasia; and submucous fibrosis. Review articles, experimental studies, case-reports, commentaries, letters to the Editor, unpublished articles and articles published in languages other than English were not sought. The pattern of the present study was customized to mainly summarize the relevant information. RESULTS Thirteen studies were included. In these studies, the number of patients ranged between 5 patients and 147 individuals with mean ages ranging between 51 years and 62.2 years. Oral premalignant lesions, which were investigated were leukoplakia, erythroplakia, erythro-leukoplakia and verrucous hyperplasia. Reported number of premalignant lesions ranged between 5 and 225. Laser wavelength, duration of irradiation and power density were 585-660nm, 60s to 16.6min and 100-150mW/cm(2), respectively. Aminolevulinic acid, chlorine-e6, meta-tetrahydroxyphenylchlorin and photofrin were used as photosensitizer. The frequency of PDT application ranged between once and 12 times. Complete, partial and no response to PDT was shown by 27-100%, 5-50% and 0-25% of pre-malignant lesions, respectively. The recurrence rate of pre-malignant lesions was up to 36%. CONCLUSION PDT is effective in the overall management of oral premalignant lesions.
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Affiliation(s)
- Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz A Al-Kheraif
- Dental Biomaterials Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11541, Saudi Arabia
| | - Talat Qadri
- Division of Periodontology, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | | | - Asma Ahmed
- Department of Laser Dentistry, RWTH Aachen University, Aachen, Germany; Department of Dentistry, Lifecare Hospital, Abu Dhabi, United Arab Emirates
| | - Saman Warnakulasuriya
- Department of Oral Medicine, King's College London and WHO Collaborating Centre for Oral Cancer and Precancer, London, United Kingdom
| | - Fawad Javed
- Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
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Yang DF, Lee JW, Chen HM, Hsu YC. Topical methotrexate pretreatment enhances the therapeutic effect of topical 5-aminolevulinic acid-mediated photodynamic therapy on hamster buccal pouch precancers. J Formos Med Assoc 2014; 113:591-9. [DOI: 10.1016/j.jfma.2014.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 02/24/2014] [Accepted: 03/19/2014] [Indexed: 12/13/2022] Open
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Costa IDSM, Abranches RP, Garcia MTJ, Pierre MBR. Chitosan-based mucoadhesive films containing 5-aminolevulinic acid for buccal cancer's treatment. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2014; 140:266-75. [PMID: 25190225 DOI: 10.1016/j.jphotobiol.2014.08.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/22/2014] [Accepted: 08/05/2014] [Indexed: 02/04/2023]
Abstract
Photodynamic therapy (PDT) is a relatively new method to treat various kinds of tumors, including those of the oral cavity. The topical 5-ALA-PDT treatment for tumors of the oral mucosa is preferred, since when administered systemically, there is a general photosensitization drawback in the patient. However, 5-ALA is a hydrophilic molecule and its penetration and retention is limited by topical route, including oral mucosa. We propose a topical delivery system of chitosan-based mucoadhesive film, aiming to promote greater retention of 5-ALA in tissue. The chitosan (CHT) films (4% w/w) were prepared using the solvent evaporation/casting technique. They were tested without 5-ALA resulting in permeability to water vapor (W.V.P=2.15-8.54 g mm/(h cm(2)Pa) swelling ∼300.0% (±10.5) at 4 h or 24 h and in vitro residence time >24 h for all tests. CHT films containing 10.0% (w/w) 5-ALA have resulted in average weight of 0.22 g and thickness of 0.608 mm as suitable characteristics for oral application. In the presence of CHT films both in vitro permeation and retention of 5-ALA (1.0% or 10.0%) were increased. However, 10.0% 5-ALA presented highest values of permeation and retention (∼4 and 17 times respectively, compared to propylene glycol vehicle). On the other hand, in vitro mucoadhesion of CHT films was decreased (18.2-fold and 3.1-fold) by 5-ALA addition (1.0% or 10.0% respectively). However, CHT film containing 10.0% of 5-ALA can be a potential delivery system for topical use in the treatment of tumors of the oral cavity using PDT because it favored the retention of 5-ALA in this tissue and has shown convenient mucoadhesion.
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Affiliation(s)
- Irina dos Santos Miranda Costa
- School of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho 373, 21.941.902 Rio de Janeiro, RJ, Brazil
| | - Renata Pereira Abranches
- School of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho 373, 21.941.902 Rio de Janeiro, RJ, Brazil
| | - Maria Teresa Junqueira Garcia
- School of Pharmacy, University of Uberaba, Av. Nenê Sabino, 1801, Bairro Universitário, 38055-500 Uberaba, MG, Brazil
| | - Maria Bernadete Riemma Pierre
- School of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho 373, 21.941.902 Rio de Janeiro, RJ, Brazil.
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Yu CH, Lin HP, Cheng SJ, Sun A, Chen HM. Cryotherapy for oral precancers and cancers. J Formos Med Assoc 2014; 113:272-7. [DOI: 10.1016/j.jfma.2014.01.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 01/15/2014] [Accepted: 01/19/2014] [Indexed: 12/12/2022] Open
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Xu J, Xue T, Bao Y, Wang DH, Ma BL, Yin CY, Yang GH, Ren G, Lan LJ, Wang JQ, Zhang XL, Zhao YQ. Positive therapy of andrographolide in vocal fold leukoplakia. Am J Otolaryngol 2014; 35:77-84. [PMID: 24444776 DOI: 10.1016/j.amjoto.2013.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 12/04/2013] [Accepted: 12/13/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE Vocal fold leukoplakia is a premalignant precursor of squamous cell carcinoma. Although many efforts have been contributed to therapy of this disease, none exhibits a satisfactory result. The aims of this study were to investigate the effectiveness and feasibility of andrographolide therapy in vocal fold leukoplakia and to explore the preliminary mechanism underlying. MATERIALS AND METHODS Forty-one eligible patients were enrolled in the study. The patients were treated for 10-minute exposures of 5 ml (25mg/ml) andrographolide injection aerosols twice a day, and 2 weeks was considered as one treatment course. Electronic laryngoscope was used to observe the condition of vocal fold leukoplakia during the treatment. Every patient received one or two treatment courses, and the follow-up was carried out for 12 months. Toxic reactions of treatments were evaluated on the basis of the standards of the United States MD Anderson Cancer Center. Moreover, laryngeal carcinoma cell line Hep2 was applied to explore the mechanism of effect of andrographolide. Anti-proliferative effect on Hep2, cell nuclear morphology, express of mitogen-activated protein kinases (MAPK) and pro-apoptotic protein were detected after andrographolide treatment. RESULTS We found that andrographolide exhibited significant curative effects on treatments, which were accompanied by thinning of the lesion of leukoplakia, reduction in the whitish surface area, and return of pink or red epithelium. A complete response up to 85% was observed, and no toxic side effect events occurred during the study. No patient with a complete response had a recurrence in the follow-up. Moreover, cellular experiments in Hep2 indicated that andrographolide activated MAPK pathway and caspase cascade, and finally induced apoptosis in laryngeal carcinoma cell. CONCLUSIONS The advantages of andrographolide are connected with minimally invasive and localized character of the treatment and no damage of collagenous tissue structures, which are more convenient and less painful for patients. These results suggest that andrographolide treatment is a viable strategy for curing vocal fold leukoplakia.
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Panwar A, Lindau R, Wieland A. Management for premalignant lesions of the oral cavity. Expert Rev Anticancer Ther 2014; 14:349-57. [DOI: 10.1586/14737140.2013.842898] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Yang DF, Lee JW, Chen HM, Huang Z, Hsu YC. Methotrexate enhances 5-aminolevulinic acid-mediated photodynamic therapy-induced killing of human SCC4 cells by upregulation of coproporphyrinogen oxidase. J Formos Med Assoc 2014; 113:88-93. [PMID: 24485831 DOI: 10.1016/j.jfma.2013.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 12/24/2013] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND/PURPOSE Topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is effective for treatment of oral precancerous and cancerous lesions. This in vitro study tried to examine whether the SCC4 cell killing by ALA-PDT was enhanced by pretreatment of methotrexate (MTX). METHODS To measure the SCC4 cell killing abilities by MTX-pretreated ALA-PDT (MTX-ALA-PDT), the SCC4 cells were pretreated with 0 mg/L, 0.001 mg/L, 0.01 mg/L, 0.1 mg/L, or 1 mg/L of MTX for 72 hours, then incubated with 0 mM, 0.0625 mM, 0.125 mM, 0.187 mM, 0.25 mM, or 0.375 mM ALA for 4 hours, and subsequently illuminated with a 640-nm light-emitting diode array at a light dose of 10 J/cm(2). The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was conducted at 24 hours to quantify SCC4 cell survival rates after MTX-ALA-PDT treatment. Western blot analyses were used to examine the MTX-mediated enhancement in the expressions of the heme production-related enzymes, coproporphyrinogen oxidase (CPOX), protoporphyrinogen oxidase (PPOX), and ferrochelatase, in the MTX-preconditioned SCC4 cells. RESULTS Pretreatment of SCC4 cells by 0.001 mg/L MTX for 72 hours resulted in a significant augmentation in MTX-ALA-PDT-induced killing of SCC4 cells (p < 0.05). The SCC4 cells treated with 0.001 mg/L MTX for 72 hours showed a significant and 1.65-fold increase in CPOX expression compared with the control SCC4 cells without MTX treatment (p < 0.05). However, no significant changes in the expressions of PPOX and ferrochelatase were observed in the SCC4 cells pretreated with different concentrations of MTX. CONCLUSION MTX enhances ALA-PDT-induced SCC4 cell killing through upregulation of CPOX expression and subsequent increase in intracellular protoporphyrin IX production in SCC4 cells.
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Affiliation(s)
- Deng-Fu Yang
- Graduate Program, Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Jeng-Woei Lee
- Department of Life Science, Tzu Chi University, Hualien, Taiwan
| | - Hsin-Ming Chen
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Zheng Huang
- Cancer Center, University of Colorado Denver Cancer Center, CO, USA
| | - Yih-Chih Hsu
- Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan, Taiwan; Center for Nanotechnology, Chung Yuan Christian University, Taoyuan, Taiwan; Center of Biomedical Technology, Chung Yuan Christian University, Taoyuan, Taiwan.
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Panwar A, Lindau R, Wieland A. Management for premalignant lesions of the oral cavity. Expert Rev Anticancer Ther 2014:1-9. [PMID: 24397698 DOI: 10.1586/14737140.2014.842898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Premalignant lesions of the oral cavity present as visibly abnormal areas of mucosa and may be a source of significant anxiety for the patient and the clinician. Suspicious lesions should be biopsied to evaluate for dysplasia. The risk of malignant transformation may relate to patient characteristics, environmental risk factors and genetic alterations. Management of such lesions hinges on risk modification, surveillance, symptom management and directed biopsies. Excision or ablation of dysplastic lesions is indicated. We review the current evidence relating to management of premalignant lesions of the oral mucosa and make recommendations for practice patterns.
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Affiliation(s)
- Aru Panwar
- Division of Head and Neck Surgery, University of Nebraska Medical Center, Omaha, NE, USA
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Siddiqui SH, Awan KH, Javed F. Bactericidal efficacy of photodynamic therapy against Enterococcus faecalis in infected root canals: A systematic literature review. Photodiagnosis Photodyn Ther 2013; 10:632-43. [DOI: 10.1016/j.pdpdt.2013.07.006] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/27/2013] [Accepted: 07/30/2013] [Indexed: 01/10/2023]
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Breskey JD, Lacey SE, Vesper BJ, Paradise WA, Radosevich JA, Colvard MD. Photodynamic therapy: occupational hazards and preventative recommendations for clinical administration by healthcare providers. Photomed Laser Surg 2013; 31:398-407. [PMID: 23859750 DOI: 10.1089/pho.2013.3496] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE Photodynamic therapy (PDT) as a medical treatment for cancers is an increasing practice in clinical settings, as new photosensitizing chemicals and light source technologies are developed and applied. PDT involves dosing patients with photosensitizing drugs, and then exposing them to light using a directed energy device in order to manifest a therapeutic effect. Healthcare professionals providing PDT should be aware of potential occupational health and safety hazards posed by these treatment devices and photosensitizing agents administered to patients. MATERIALS AND METHODS Here we outline and identify pertinent health and safety considerations to be taken by healthcare staff during PDT procedures. RESULTS Physical hazards (for example, non-ionizing radiation generated by the light-emitting device, with potential for skin and eye exposure) and chemical hazards (including the photosensitizing agents administered to patients that have the potential for exposure via skin, subcutaneous, ingestion, or inhalation routes) must be considered for safe use of PDT by the healthcare professional. CONCLUSIONS Engineering, administrative, and personal protective equipment controls are recommendations for the safe use and handling of PDT agents and light-emitting technologies.
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Affiliation(s)
- John D Breskey
- California State University, Fullerton, College of Health and Human Development, Department of Health Science, Fullerton 92831, California, USA.
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