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Photodynamic therapy as the "last hope" for tongue-based carcinoma

Introduction

The management of base of tongue carcinoma continue to be a major challenge in head and neck oncology. Our aim in this prospective study was to evaluate the outcome following ultrasound-guided interstitial photodynamic therapy (US-iPDT) of stage IV tongue base carcinoma. Patients’ reports on quality of life with clinical and radiological evaluation were the main end point parameters used to assess the outcome.

Material/methods

Thirty-three consecutive patients were referred to the UCLH Head and Neck Centre for treatment of advanced tongue base cancer. Two-thirds of the patients had not been offered further treatment. It was decided that the only available option is to offer US-iPDT under general anaesthesia, using mTHPC as the photosensitising agent. Following treatment, patients were followed-up for a mean of 18 months (Min 8, Max 44).

Results

11/14 patients who presented with breathing problems reported improvement after treatment. Also, 28/33 reported improvement of swallowing. Improvement of speaking was reported by 15/18 patients.

Clinical assessment showed that two-thirds of the patients had “good response” to the treatment and a third reported “moderate response”. Radiological assessment comparing imaging 6-week post-PDT to the baseline showed stable pathology with no change in size in 6 patients, minimal response in 7 patients, moderate response in 12 patients and significant response in 5 patients.

Eleven patients died; Seven of which due to locoregional metastasis. Kaplan-Meir survival curve was generated from the survival and follow-up data.

Conclusions

Photodynamic therapy is a successful palliative modality in the treatment of advanced tongue base carcinoma.

Author information

Correspondence to Waseem Jerjes.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Jerjes, W., Upile, T., Hamdoon, Z. et al. Photodynamic therapy as the "last hope" for tongue-based carcinoma. Head Neck Oncol 2, O27 (2010). https://doi.org/10.1186/1758-3284-2-S1-O27

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Keywords

  • Significant Response
  • Photodynamic Therapy
  • Radiological Evaluation
  • Radiological Assessment
  • Moderate Response