Is photodynamic therapy a good alternative to surgery and radiotherapy in the treatment of head and neck cancer?

The mainstay treatments for head and neck carcinomas are surgery, radiotherapy and chemotherapy. These treatment options may be associated with considerable complications. Radical radiotherapy and chemotherapy can generally be employed only once, which presents difficulties in cases of recurrent disease or second primaries within the irradiated field. Salvage surgery at the same site is often difficult, due to progressive tissue loss. In this respect photodynamic therapy (PDT) seems to be a good alternative treatment option for small, localized tumors; with a good outcome and with excellent functional and cosmetic results. Selected patients with advanced cancer of the head and neck, who have exhausted other treatment options, can also achieve improvement in quality of life with PDT. The advantages of PDT compared with surgery or radiotherapy are reduced long-term morbidity and the fact that PDT does not compromise future treatment options for recurrent, residual or second primary disease.