J Med Assoc Thai 1999; 82 (11):1111

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Photodynamic Therapy for Residual or Recurrent Cancer of the Nasopharynx
Kulapaditharom B Mail, Boonkitticharoen V

Adequate or effective treatments are not always available for most recurrent or residual
nasopharyngeal cancers (NPC). Photodynamic therapy (PDT) using hematoporphyljn derivative
(HpD) was evaluated for its effectiveness in treating patients, who conventionally failed. with
curative or palliative intent. Thirteen patients were treated from March 1994 to November 1998.
PDT was given to eradicate tumor cells, debulk tumor mass for other treatment options, and to
resolve obstruction. Long-term tumor control could be achieved in 6 patients with localized
lesions at T1-T2 stages. The mean disease free survival time was 25.8 months (range 5-61 months).
For tumors beyond T2 stage (7 cases), PDT in combination with chemotherapy, laser surgery or
radiotherapy induced complete response in I out of 5 patients (survival time = 40 months) and
partial response in the rest (survival time = 16-37 months). In two patients who refused or were in
tolerable to further treatment, PDT yielded useful palliative results (i.e. resolve nasal obstruction
and epistaxis). On an overall basis, the average survival time for these patients with relatively
advanced diseases was 24.7 months (range 9-40 months).
Our study demonstrated that HpD-PDT could effectively control locally recurrent or
residual NPC at T1-T2 stages and offered good palliation for more advanced diseases. Combined
PDT and chemotherapy seemed to prolong survival time for a period longer than 2 years in T3-T 4
Key word Photodynamic Therapy, Nasopharyngeal Cancer Residual Cancer, Recurrent Cancer

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