Interstitial photodynamic therapy with rotating and reciprocating optical fibers - Clinical trial of three patients with squamous cell carcinoma of the tongue

BACKGROUND. Photodynamic therapy (PDT) is an effective treatment modality t hat allows selective destruction of malignant tumor cells. However, because of the difficulty in exposing deeper areas of rumors, the modality has str ictly limited indications. In this study, the authors introduce a new metho d for delivering laser light to a three-dimensional, wide area with the pur pose of improving the therapeutic value of PDT. METHODS. Three patients with squamous cell carcinoma of the tongue were tre ated with the present course. After administering porfimer sodium, laser-pr oof tubes were inserted through the tumor, and optical fibers were passed t hrough the tubes. Pulse laser was emitted from the obliquely prepared fiber tip and distributed toward the target area while rotating and reciprocatin g the optical fiber. RESULTS. Two patients achieved a complete response without any complication s or functional disabilities. The third patient, however, had a partial res ponse and required surgery. CONCLUSIONS, The results indicate the capability of distributing laser ligh t to an entire area of solid tumor. However, the ideal dose of laser light for the treatment of tumors remains unknown. Interstitial PDT will be more efficacious and reliable after the dosimetry is established. (C) 2001 Ameri can Cancer Society.