Postoperative photodynamic therapy as a new adjuvant treatment after robot-assisted salvage surgery of recurrent squamous cell carcinoma of the base of tongue

World Journal of Surgical Oncology

Pierre Delaere¹  Esther Hauben²  Robert Hermans³  Paul Clement⁴  Sandra Nuyts⁶  Jeroen Meulemans⁵  Vincent Vander Poorten⁵ 

[1] Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium;Pathology, University Hospitals Leuven, Leuven, Belgium;Radiology, University Hospitals Leuven, Leuven, Belgium;Medical Oncology, University Hospitals Leuven, Leuven, Belgium;Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium;Department of Oncology, Section Radiation Oncology, KU Leuven, Leuven, Belgium

关键词: Chemoradiation;    Salvage surgery;    Transoral robotic surgery;    Photodynamic therapy;    Oropharyngeal cancer;   

Others  :  1221217
DOI  :  10.1186/s12957-015-0630-6

 received in 2015-02-17, accepted in 2015-06-16,  发布年份 2015

【 摘 要 】

Background

For patients who remain with involved resection margins after transoral robot-assisted salvage surgery (TORS) for recurrent squamous cell carcinoma (SCC) at the base of tongue (BOT) following primary (chemo)radiotherapy, further adjuvant treatment options are very limited. We want to report on our preliminary experience with a new adjuvant strategy using postoperative temoporfin-mediated photodynamic therapy for this indication.

Methods

Two patients with recurrent SCC after primary (chemo)radiotherapy of the BOT were treated with TORS, but unfortunately remained with involved resection margins on the postoperative pathology report. If left without additional treatment, these patients are prone to further recurrence. Temoporfin-mediated photodynamic therapy was used as a new adjuvant approach to treat the remaining microscopic disease at the resection margins.

Results

Good oncological and functional results were obtained in these patients, now treated for a recurrence, after a preceding full course of radiotherapy. Both are disease free at 42 and 24 months of follow-up and are able to speak, breathe, and eat normally.

Conclusions

In selected patients that have undergone salvage surgery with positive resection margins, postoperative temoporfin-mediated photodynamic therapy can result in a good oncological and functional outcome.

【 授权许可】

   
2015 Vander Poorten et al.

【 图 表 】

Fig. 1.

Fig. 2.

【 参考文献 】

• [1]de Arruda FF, Puri DR, Zhung J, Narayana A, Wolden S, Hunt M et al.. Intensity-modulated radiation therapy for the treatment of oropharyngeal carcinoma: the Memorial Sloan-Kettering Cancer Center experience. Int J Radiat Oncol Biol Phys. 2006; 64:363-73.
• [2]Pederson AW, Haraf DJ, Witt ME, Stenson KM, Vokes EE, Blair EA et al.. Chemoradiotherapy for locoregionally advanced squamous cell carcinoma of the base of tongue. Head Neck. 2010; 32:1519-27.
• [3]Reynolds LF, Rigby MH, Trites J, Hart R, Taylor SM. Outcomes of transoral laser microsurgery for recurrent head and neck cancer. J Laryngol Otol. 2013; 127:982-6.
• [4]White H, Ford S, Bush B, Holsinger FC, Moore E, Ghanem T et al.. Salvage surgery for recurrent cancers of the oropharynx: comparing TORS with standard open surgical approaches. JAMA Otolaryngol Head Neck Surg. 2013; 139:773-8.
• [5]Tan IB, Dolivet G, Ceruse P, Vander Poorten V, Roest G, Rauschning W. Temoporfin-mediated photodynamic therapy in patients with advanced, incurable head and neck cancer: a multicenter study. Head Neck. 2010; 32:1597-604.
• [6]Jerjes W, Upile T, Radhi H, Hopper C. Photodynamic therapy and end-stage tongue base cancer: short communication. Head Neck Oncol. 2011; 3:49. BioMed Central Full Text
• [7]Digonnet A, Hamoir M, Andry G, Haigentz M, Takes RP, Silver CE et al.. Post-therapeutic surveillance strategies in head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol. 2013; 270:1569-80.