Photodynamic therapy of early cancer in the upper aerodigestive tract and bronchi: instrumentation and clinical results

G. Wagnières

doi:10.1117/12.2283681

21 January 1990 Photodynamic therapy of early cancer in the upper aerodigestive tract and bronchi: instrumentation and clinical results

G. Wagnières

Author Affiliations +

Proceedings Volume 10306, Future Directions and Applications in Photodynamic Therapy; 103060J (1990) https://doi.org/10.1117/12.2283681
Event: SPIE Institutes for Advanced Optical Technologies 6, 1990, San Diego, California, United States

Abstract

A complete instrumentation has been developed for photodynamic therapy (PDT) and combined PDT- hyperthermia in the upper aerodigestive tract and the bronchi. These instruments consist of several light distributors which permit optimal light dosage to "superficial" tumors, as well as an injector for laser beams into an optical fiber and a fiberoptic coupler for cw laser beam powers at least 100 Watts. PDT is carried out with HpD and Photofrin II at 630 nm, whereas occasional simultaneous hyperthermia is at 1.06 microns. PDT of 41 cases of "early" squamous cell carcinoma is reported with follow-up between 5 and 62 months. In the oesophagus and bronchi the results are good for cancers staged in situ or microinvasive at endoscopy (2 recurrences for 23 lesions treated). For more advanced cancers (submucosal in the oesopha- gus or invading the bronchial cartilage) the results are less satisfactory with 3 recurrences for 8 lesions treated. In the bronchi (1 case) and the oesophagus (1 case) the largest disease - free survival is now more than 5 years. We encountered 6 complications (3 cicatrical stenosis, 2 fistulae, 1 severe sunburn), most of them resulting from the lack of selectivity of PDT with these porphyrin mixtures at the applied conditions. These experiments show that PDT is efficient at destroying early squamous cell carcinomas in the pharynx, oesophagus and bronchi. Tumour selectivity of HpD and photofrin II is poor in the aerodigestive tract lined with squamous cell epithelium. The future lies in the synthesis of a more selective efficient photosensitizer.

Citation Download Citation

G. Wagnières "Photodynamic therapy of early cancer in the upper aerodigestive tract and bronchi: instrumentation and clinical results", Proc. SPIE 10306, Future Directions and Applications in Photodynamic Therapy, 103060J (21 January 1990); https://doi.org/10.1117/12.2283681

ACCESS THE FULL ARTICLE

INSTITUTIONAL
Select your institution to access the SPIE Digital Library.

SELECT YOUR INSTITUTION

PERSONAL
Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.

PERSONAL SIGN IN

No SPIE Account? Create one

PURCHASE THIS CONTENT

SUBSCRIBE TO DIGITAL LIBRARY

50 downloads per 1-year subscription

Members: $195

Non-members: $335 ADD TO CART

25 downloads per 1 - year subscription

Members: $145

Non-members: $250 ADD TO CART

PURCHASE SINGLE ARTICLE

Includes PDF, HTML & Video, when available