Photodynamic therapy using Photofrin and excimer dye laser treatment for superficial oral squamous cell carcinomas with long-term follow up

- In this report, we describe and assess the efficacy and safety of Photofrin-mediated PDT for superficial SCC in the oral cavity with long-term follow up (over 5 years) of patients.
- By analyzing tumor color and comparing anti-tumor treatment effects, we found that red lesions had a significantly higher relapse rate than white lesions.
- The wider spot and low intensity irradiation decreased the frequency of relapse significantly in comparison standard illumination.

ObjectivesPhotodynamic therapy (PDT) is a very effective treatment for superficial malignancies that does not result in loss of normal tissue. Here, we report successful PDT treatment of superficial oral cancers and its clinical outcome with long-term follow up.Materials and methodsThirty-four superficial oral squamous cell carcinomas were treated with PDT, and the effects were evaluated. Each patient received Photofrin (2 mg/kg) intravenously 48 h prior to light irradiation. Photoradiation was performed at doses of 100-150 J/cm2 using a 630-nm wavelength excimer dye laser.ResultsSix months after PDT, 30 patients (88.2%) showed complete responses while 9 patients (26.5%) had local relapses during long-term follow-up. The 5-year overall survival, disease-specific survival, and disease-free survival rates were 76.5%, 84.6%, and 63.3%, respectively. Lesions with red patches had a significantly higher recurrence rate than lesions with white patches. Accurate evaluation of the extent of lesions and appropriate photoradiation were important in improving outcomes. Adverse events observed included sunburn and sequestrum formation of alveolar bone. No abnormal laboratory values or systemic complications were observed.ConclusionPDT using Photofrin as the photosensitizer is an effective treatment modality for superficial oral carcinomas, with excellent healing and minimal side effects.