Temoporfin mediated photodynamic therapy in patients with local persistent and recurrent nasopharyngeal carcinoma after curative radiotherapy: A feasibility study

H. J. Nyst, M. A. Wildeman, S. R. Indrasari, B. Karakullukcu, R. L. P. van Veen, M. Adham, F. A. Stewart, P. C. Levendag, H. J. C. M. Sterenborg, I. B. Tan

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Abstract

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 <10 mm) 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: 0.15 mg/kg Foscan (R); 96 h drug-light interval; B: drug dose of 0.10 mg/, 48 h drug-light interval; C: drug dose of 0.075 mg/kg, 24 h 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. (C) 2012 Elsevier B.V. All rights reserved
Original languageEnglish
Pages (from-to)274-281
JournalPhotodiagnosis and photodynamic therapy
Volume9
Issue number3
DOIs
Publication statusPublished - 2012

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