Temoporfin mediated photodynamic therapy in patients

Photodiagnosis Photodyn Ther 2012 Sep 2012

HJ Nyst, MA Wildeman, SR Indrasari, B Karakullukcu, RL van Veen, M Adham, FA Stewart, PC Levendag, HJ Sterenborg, IB Tan

Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

BACKGROUND: The treatment of persistent and recurrent nasopharyngeal carcinoma (NPC) remains a challenge, especially in Indonesia. We investigated the safety and efficacy of temoporfin mediated photodynamic therapy (PDT) for patients with local persistent and recurrent NPC.

MATERIAL AND METHODS: Twenty-two patients with persistent and recurrent NPC (maximum tumor depth <10mm) underwent PDT under local anesthesia with use of a nasopharyngeal light applicator. Three different drug doses and light intervals have been administered: treatment arm A: 0.15mg/kg Foscan(®); 96h drug-light interval; B: drug dose of 0.10mg/, 48h drug-light interval; C: drug dose of 0.075mg/kg, 24h drug-light interval. Toxicity was measured by using the CTCAE 3.1 scale.

RESULTS: Arm A consisted of eight patients, arms B and C consisted of seven patients. The treatment procedure was well tolerable under local anesthesia. The most common grade III toxicities for all groups is headache (n=7; 33%). No grade IV toxicity was seen. One patient died 2 days after treatment due to a misdiagnosed pneumonia. In 17 of the 22 patients a biopsy was performed after 40 weeks and showed no tumor in all biopsies. Arm A seems, in addition to comparable toxicity, clinically more effective than arms B and C.

CONCLUSION: The present study demonstrated that temoporfin mediated photodynamic therapy is a relatively simple technique that can be utilized to treat residual or recurrent nasopharyngeal cancer, restricted locally to the nasopharynx.