Photodynamic therapy of head and neck cancer-what's old and what's new

Photodynamic therapy (PDT) is a FDA approved minimally invasive medical treatment modality that utilizes light in the presence of oxygen to activate photosensitizing agents that are relatively selectively concentrated in abnormal or neoplastic cells resulting in cell death. At the present time, PDT has been approved for clinical treatment in the United States, European Union, Canada, Russia, and Japan. In theEUFoscan has been approved for the treatment of early head and neck cancers and palliative treatment of head and neck cancer. In the United States, PDT treatment of head and neck cancer is performed off label using Photofrin, as to date there are no photosensitizers approved by the U.S. FDA for the treatment of head and neck cancers. PDTis an excellent minimally invasive modality for the treatment of carcinomas of the head and neck as the treatment preserves normal tissue. First and second generation photosensitizer PDT has been effective in the treatment of early head and neck cancers, including severe premalignant dysplasia, Tis, T1, and T2 cancers of the oral cavity, pharynx and larynx with complete response rates of 71-90%. In addition, combination therapies and targeted therapies are being investigated that may improve the therapeutic efficacy of PDT to treat later stage disease and recurrent cancers of the head and neck, including ChemoPDT and Photoimmunotherapy (PIT).