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Photodynamic Therapy for Residual or Recurrent Cancer of the Nasopharynx

BOONCHU KULAPADITHAROM, M.D.*, VIPA BOONKITTICHAROEN, Ph.D.**

Affiliation : * Department of Otolaryngology, ** Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok I 0400, Thailand.

Abstract
Adequate or effective treatments are not always available for most recurrent or residual nasopharyngeal cancers (NPC). Photodynamic therapy (PDT) using h~matoporphyljn derivative (HpD) was evaluated for its effectiveness in treating patients, who conventionally failed. with curative or palliative intent. Thirteen patients were treated from March 1994 to November 199X. PDT was given to eradicate tumor cells, debulk tumor mass for other treatment options, and to resolve obstruction. Long-term tumor control could be achieved in 6 patients with localized lesions at TrT2 stages. The mean disease free survival time was 25.8 months (range 5-61 months). For tumors beyond T 2 stage (7 cases), PDT in combination with chemotherapy, laser surgery or radiotherapy induced complete response in I out of 5 patients (survival time = 40 months) and partial response in the rest (survival time = 16-37 months). In two patients who refused or were in tolerable to further treatment, PDT yielded useful palliative results (i.e. resolve nasal obstruc- tion and epistaxis). On an overall basis, the average survival time for these patients with rela- tively advanced diseases was 24.7 months (range 9-40 months).
Our study demonstrated that !'fpD-PDT could effectively control locally recurrent or residual NPC at T r T 2 stages and offered good palliation for more advanced diseases. Combined PDT and chemotherapy seemed to prolong survival time for a period longer than 2 years in T y T 4 tumors.

Keywords : Photodynamic Therapy, Nasopharyngeal Cancer Residual Cancer, Recurrent Cancer


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