Chlorin-E6-based photodynamic therapy (PDT) and photodiagnosis (PD) in the palliative treatment of head neck cancer (HNC)

Objective:

Despite its approval PDT has not well established In the palliative therapy of HNC. Furthermore we have no standards for this procedure.

Material & methods:

We performed a retrospective analysis of the treated HNC patients of our department between 11 – 2016 and 10 – 2018 in order to describe daily practice, and to develop Standards and new Research projects. We included 35 patients (10 female, 25 male, median age 71 years, range 18 – 99). Inclusion criteria were histological confirmed squamous cell carcinoma and informed consent of the patient. The patients have got 1 mg/kg Chlorin E6 IV 3h before starting PD/PDT. Then we performed PD in optical and/or spectroscopical (405nm) technique. The fibre application was corrected and the PDT was done by a red laser (670nm). Data are summarized in MS Excel.

Results:

Tumour localizations – 9x tongue/mouth, 9x larynx, 7x nose/paranasal sinus, 4x palate and buccal region, and 3x pharynx. Aims of PDT were 33x tumour reduction, and 2x decreasing symptom burden. The follow-up interval was 5 month (range 1 – 30); 24 patients are alive, 8 patients died, 3 were lost in follow up. We performed 2 PDT per patient (range 1 – 19). The application technique was interstitial in 12 patients, frontal in 10 patients and cylindric in 13 patients. The used energy was 200 mW/cm² or 200 mW/cm. PDT was the only therapy in 15 patients, in multimodal combinations in 20 patients. We have seen 14 CR, 10 PR, 10 SD and 1 PD. At the end 3 patients would never repeat PDT. Further 3 have had bad experiences (pain). 19 patients would repeat PDT.

Conclusion:

PDT is an effective procedure to get local control in palliative situation of HNC. Further prospective research should focus on role of PD and the place of PDT in multimodal therapy strategies.

Publication History

Publication Date:
23 April 2019 (online)