J Med Assoc Thai 2000; 83 (3):249

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Photodynamic Therapy in Management of Head and Neck Cancers and Precancerous Lesions
Kulapaditharom B Mail, Boonkitticharoen V

Photodynamic therapy (PDT) is a new form of cancer treatment with low morbidity. In
this study, PDT was evaluated for its effectiveness in management of recurrent or widespread
precancerous lesions, primary cancers in inoperable sites, recurrent or residual cancers which
were refractory to radiotherapy and chemotherapy, and advanced tumors in the head and neck.
Fifty-one patients were treated over a period of 5 years. A 91.67 per cent complete response rate
was observed forT
1
tumors (primary and recurrence) with a recurrent rate of 27.27 per cent. Naso-
pharyngeal carcinoma was highly responsive to PDT since all T
1
and T2 tumors responded
completely. This was in contrast to cancers in the soft palate which failed in most cases possibly
due to inadequate light dose distribution. PDT was remarkably effective in curing premalignant
diseases ( 100% complete response rate). Postoperative PDT was equally effective in treating the
microscopic residual malignancy. For advanced tumors, PDT in adjunct to conventional modalities
could induce complete response in 5 out of the 10 patients and resolve symptoms in 4 cases. The
mean follow-up time for this series was 28.3 months (range 3-66 months). In conclusion, PDT is
a useful modality for the treatment of head and neck tumors and precancerous lesions presenting
in forms or under conditions that posed considerable difficulties in management by conventional
approaches.
Key word : Photodynamic Therapy, Head and Neck Cancers, Primary and Recurrent Cancers,
Precancerous Lesions

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