Photodynamic therapy with topical 5-aminolevulinic acid as a post-operative adjuvant therapy for an incompletely resected primary nasopharyngeal papillary adenocarcinoma: A case report
✍ Scribed by Cheng-Ping Wang; Yih-Leong Chang; Chin-Tin Chen; Ting-Hua Yang; Pei-Jen Lou
- Publisher
- John Wiley and Sons
- Year
- 2006
- Tongue
- English
- Weight
- 131 KB
- Volume
- 38
- Category
- Article
- ISSN
- 0196-8092
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✦ Synopsis
Abstract
Background and Objectives
Surgical excision of primary nasopharyngeal papillary adenocarcinoma is sometimes incomplete with remaining microscopic disease. Post‐operative radiotherapy only has limited efficacy but may cause many complications.
Study Design/Materials and Methods
Photodynamic therapy (PDT) was used as a post‐operative adjuvant therapy for an incompletely resected primary nasopharyngeal papillary adenocarcinoma. A special form of 20% topical 5‐aminolevulinic acid (5‐ALA), which was originally a liquid form and became a gel form after applied on the nasopharynx, was used as the photosensitizer. A 2‐mm optic fiber delivered the light (633 nm wavelength) to the lesion with a fluence rate of 100 mW/cm^2^ generated by a diode laser under 5 mm 0° endoscope assistance. The total energy delivered was 150 joules/cm^2^.
Results
No significant acute side effect was noted and the nasopharyngeal wound healed rapidly. The patient is alive without locoregional recurrence or distant metastasis for 5 years. Articulation, salivation, and swallowing functions are all well preserved.
Conclusion
Post‐operative adjuvant PDT can successfully cure an otherwise difficult to treat disease with preservation of good life quality of the patient. Potential complications of PDT (e.g., photosensitivity) can be prevented by a special formulation of topical 5‐ALA preparation. Lasers Surg. Med. © 2006 Wiley‐Liss, Inc.