Abstract
Oral cancer is a global health burden with significantly poor survival, especially when the diagnosis is at its late stage. Despite advances in current treatment modalities, there has been minimal improvement in survival rates over the last five decades. The development of local recurrence, regional failure, and the formation of second primary tumors accounts for this poor outcome. For survivors, cosmetic and functional compromises resulting from treatment are often devastating. These statistics underscore the need for novel approaches in the management of this deadly disease. Photodynamic therapy (PDT) is a treatment modality that involves administration of a light-sensitive drug, known as a photosensitizer, followed by light irradiation of an appropriate wavelength that corresponds to an absorbance band of the sensitizer. In the presence of tissue oxygen, cytotoxic free radicals that are produced cause direct tumor cell death, damage to the microvasculature, and induction of inflammatory reactions at the target sites. PDT offers a prospective new approach in controlling this disease at its various stages either as a stand-alone therapy for early lesions or as an adjuvant therapy for advanced cases. In this review, we aim to explore the applications of PDT in oral cancer therapy and to present an overview of the recent advances in PDT that can potentially reposition its utility for oral cancer treatment.
Highlights
Each year, oral cancer accounts for 300,400 new cases and 145,300 cancer related deaths [1]
From the results of the retrospective studies and clinical trials, it can be concluded that Photodynamic therapy (PDT) is well-suited as a primary or alternative treatment modality for early oral cancer without nodal metastasis (i.e., T1 and T2 tumors) and is associated with significantly less morbidity compared to conventional therapy
At 6-month follow-up, nine patients had shown complete remission (CR) [43]. These findings suggest that Interstitial PDT (iPDT) can be used as a curative modality in addition to palliative care for untreatable advanced head and neck cancers
Summary
Oral cancer accounts for 300,400 new cases and 145,300 cancer related deaths [1]. Namely surgery and radiotherapy, recurrence rates for oral cancer have not improved, ranging from 30% to 47% for oral squamous cell carcinoma (SCC) [2,3]. The quality of life is compromised after conventional oral cancer treatment, with psychosocial impacts and functional disabilities such as post-treatment tissue morbidity, xerostomia, mucositis, and fibrosis being prevalent [4,5,6,7,8]. Photodynamic therapy (PDT) has been used in the treatment of cancers due to its specificity and sensitivity for tumor cells. Due to its location and direct visibility, oral precancers and cancerous lesions are an ideal model for conventional PDT. Cancers 2016, 8, 83 applications of PDT in early and advanced oral cancer therapy and present an overview of the recent advances in PDT that can potentially reposition the technique for its use in oral cancer therapy
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