Photodynamic treatment outcomes of potentially-malignant lesions and malignancies of the head and neck region: A systematic review

J Investig Clin Dent. 2018 Feb;9(1). doi: 10.1111/jicd.12270. Epub 2017 May 8.

Abstract

Aim: The aim of the present study was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral potentially-malignant disorders (PMDS) and head and neck squamous cell carcinoma (HNSCC).

Methods: From 1985 to 2015, PubMed/Medline, Google Scholar, EMBASE, and ISI Web of Knowledge were searched using different combinations of the following key words: PDT, oral precancer, leukoplakia, erythroplakia, erythroleukoplakia, verrucous hyperplasia, oral submucous fibrosis, and HNSCC. Review articles, experimental studies, case reports, commentaries, letters to the editor, unpublished articles, and articles published in languages other than English were excluded.

Results: Twenty-six studies were included in the present study. The number of patients ranged from 2 to 147, with a mean age of 50-67 years. The reported numbers of PMDS and HNSCC ranged between 5 and 225. Photosensitizers used were aminolevulinic acid, meta-tetrahydroxyphenylchlorin, Foscan, hematoporphyrin derivatives, Photofrin, Photosan, and chlorine-e6. Laser wavelength, power density, irradiation duration were 585-652 nm, 50-500 mW/cm2 , and 1-143 minutes, respectively. Complete, partial, and no response to PDT was found in 22.58%-100%, 4%-66%, and 0%-38.70% of PMDS, respectively, and 16%-100% of complete response in HNSCC patients.

Conclusion: PDT is effective in the management of PMDS and HNSCC.

Keywords: erythroplakia; leukoplakia; malignant lesion; photodynamic therapy; potentially-malignant disorder.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aminolevulinic Acid / therapeutic use
  • Carcinoma, Squamous Cell / therapy*
  • Chlorophyllides
  • Databases, Factual
  • Dihematoporphyrin Ether / therapeutic use
  • Erythroplasia / therapy*
  • Head and Neck Neoplasms / therapy*
  • Hematoporphyrins / therapeutic use
  • Humans
  • Hyperplasia / therapy*
  • Indoles / therapeutic use
  • Laser Therapy
  • Lasers
  • Leukoplakia / therapy*
  • Leukoplakia, Oral / therapy*
  • Mesoporphyrins / therapeutic use
  • Oral Submucous Fibrosis / therapy*
  • Organometallic Compounds / therapeutic use
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use
  • Porphyrins / therapeutic use
  • Squamous Cell Carcinoma of Head and Neck
  • Treatment Outcome

Substances

  • Chlorophyllides
  • Hematoporphyrins
  • Indoles
  • Mesoporphyrins
  • Organometallic Compounds
  • Photosensitizing Agents
  • Porphyrins
  • aluminum tetrasulfophthalocyanine
  • phytochlorin
  • Aminolevulinic Acid
  • Dihematoporphyrin Ether
  • temoporfin