Photodynamic therapy in treatment of squamous cell carcinoma of oral cavity with chlorine e6 photosensitizer with long-term follow up

Yury Panaseykin, V. Kapinus, E. Filonenko, V. Polkin, F. Sevrukov, M. A. Smirnova, P. Isaev, S. A. Ivanov, A. D. Kaprin
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Abstract

Photodynamic therapy is an effective method for treating superficial forms of malignant neoplasms, characterized by a minimal risk of damage to normal tissues. In this study, we presented our experience of treating cancer of the oral mucosa using photodynamic therapy, and analyzed the immediate and long-term results of treatment. 38 patients with squamous cell carcinoma of oral cavity mucosa, with a depth of invasion no more than 7 mm, were included in the study. All patients underwent photodynamic therapy with chlorine e6 based photosensitizer. Photosensitizers were administered intravenously 3 hours before irradiation, at a dosage of 1 mg/kg of the patient’s weight. Photodynamic therapy was performed with the following parameters: P – 1.0 W, Ps – 0.31 W/cm2, E – 300 J/cm2. The area of one irradiation field ranged 1.0-2.0 cm2. Treatment effect was evaluated by RECIST 1.1. Overall survival, cancer-specific survival, and disease-free survival were calculated using Kaplan-Meier curves. Evaluation of adverse events was made by .TCAE 5.0 criteria. At 35 (92.1%) out of 38 cases, complete regression was observed after photodynamic therapy. Among them in 3 out of 35 patients relapse was diagnosed in 11.5 to 43.2 months. The total number of patients who didn’t respond to treatment was 6 (15.8%). Follow-up period was 4.2-87.3 months. (mean 42.9). 34 (89.5%) out of 38 patients are alive, 1 (2.6%) died from progression, and three died from other causes. The 5-year overall survival rate was 82.1%, cancer-specific survival rate was 97.0%, and disease-free survival rate was 81.1%. Among the factors significantly (p < 0.05) influencing relapse-free survival: depth of invasion < 5 mm (p – 0.013) and the presence of leukoplakia (p – 0.007). When assessing cancer-specific survival, factors worsening the prognosis were: age >70 years (p – 0.034) and the presence of leukoplakia (p – 0.007). Photodynamic therapy is an alternative treatment method of oral cancer superficial lesions, in case of proper assessment of primary lesion and in case of possibility of full irradiation of the tumor. Moreover, after using photodynamic therapy, the underlying connective-muscular structures are preserved, which promotes rapid healing with minimal scarring, the functions of the affected organ remain intact, and cosmetic defects do not form.
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用氯e6光敏剂治疗口腔鳞状细胞癌的光动力疗法及长期随访
光动力疗法是治疗浅表恶性肿瘤的有效方法,其特点是对正常组织的损伤风险极小。在这项研究中,我们介绍了使用光动力疗法治疗口腔黏膜癌的经验,并分析了治疗的近期和远期效果。研究共纳入了 38 名口腔黏膜鳞状细胞癌患者,侵犯深度不超过 7 毫米。所有患者都接受了基于氯e6光敏剂的光动力疗法。光敏剂在照射前 3 小时静脉注射,剂量为患者体重的 1 毫克/千克。光动力疗法的参数如下:P - 1.0 W,Ps - 0.31 W/cm2,E - 300 J/cm2。一个照射野的面积为 1.0-2.0 平方厘米。治疗效果根据 RECIST 1.1 进行评估。总生存率、癌症特异性生存率和无病生存率采用 Kaplan-Meier 曲线进行计算。不良反应评估采用.TCAE 5.0标准。在 38 例患者中,有 35 例(92.1%)在光动力治疗后完全消退。其中,35 例患者中有 3 例在 11.5 至 43.2 个月后复发。对治疗无效的患者共有 6 人(15.8%)。随访时间为 4.2-87.3 个月(平均 42.9 个月)。(平均 42.9 个月)。38名患者中有34人(89.5%)存活,1人(2.6%)死于病情恶化,3人死于其他原因。5年总生存率为82.1%,癌症特异性生存率为97.0%,无病生存率为81.1%。对无复发生存率有明显影响(p < 0.05)的因素包括:浸润深度小于 5 毫米(p - 0.013)和存在白斑(p - 0.007)。在评估癌症特异性生存率时,使预后恶化的因素有:年龄大于 70 岁(p - 0.034)和存在白斑(p - 0.007)。光动力疗法是治疗口腔癌表皮病变的一种替代方法,前提是对原发病灶进行适当评估,并有可能对肿瘤进行全面照射。此外,使用光动力疗法后,下层结缔组织肌肉结构得以保留,从而促进快速愈合,瘢痕最小,受影响器官的功能保持完好,也不会形成外观缺陷。
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来源期刊
Biomedical Photonics
Biomedical Photonics Medicine-Surgery
CiteScore
1.80
自引率
0.00%
发文量
19
审稿时长
8 weeks
期刊介绍: The main goal of the journal – to promote the development of Russian biomedical photonics and implementation of its advances into medical practice. The primary objectives: - Presentation of up-to-date results of scientific and in research and scientific and practical (clinical and experimental) activity in the field of biomedical photonics. - Development of united Russian media for integration of knowledge and experience of scientists and practitioners in this field. - Distribution of best practices in laser medicine to regions. - Keeping the clinicians informed about new methods and devices for laser medicine - Approval of investigations of Ph.D candidates and applicants.
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