Peter H Ahn1, Jarod C Finlay1, Shannon M Gallagher-Colombo1, Harry Quon1, Bert W O'Malley2, Gregory S Weinstein2, Ara Chalian2, Kelly Malloy2, Thomas Sollecito3, Martin Greenberg4, Charles B Simone1, Sally McNulty1, Alexander Lin1, Timothy C Zhu1, Virginia Livolsi5, Michael Feldman5, Rosemarie Mick6, Keith A Cengel1, Theresa M Busch7. 1. Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia PA, 19104, United States. 2. Department of Otolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia PA, 19104, United States. 3. Department of Otolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia PA, 19104, United States; Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia PA, 19104, United States. 4. Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia PA, 19104, United States. 5. Department of Pathology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia PA, 19104, United States. 6. Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia PA, 19104, United States. 7. Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia PA, 19104, United States. Electronic address: buschtm@mail.med.upenn.edu.
Abstract
BACKGROUND: We report on a Phase 1 trial of photodynamic therapy (PDT) for superficial head and neck (H&N) lesions. Due to known oxygen dependencies of PDT, translational measurements of lesion hemoglobin oxygen saturation (StO2) and blood volume (tHb) were studied for associations with patient outcomes. METHODS: PDT with aminolevulinc acid (ALA) and escalating light doses was evaluated for high-grade dysplasia, carcinoma-in-situ, and microinvasive carcinomas of the H&N. Among 29 evaluable patients, most (18) had lesions of the tongue or floor of mouth (FOM). Disease was intact in 18 patients and present at surgical margins in 11 patients. In 26 patients, lesion StO2 and tHb was measured. RESULTS: Local control (LC) at 24 months was 57.5% among all patients. In patients with tongue/FOM lesions LC was 42.7%, and it was 50.1% for those with intact lesions. Lesion tHb was not associated with 3-month complete response (CR), but StO2 was higher in patients with CR. In tongue/FOM lesions, baseline StO2 [mean(SE)] was 54(4)% in patients (n=12) with CR versus 23(8)% in patients (n=6) with local recurrence/persistence (p=0.01). Similarly, for intact disease, baseline StO2 was 54(3)% in patients (n=10) with CR versus 28(8)% in patients (n=5) without CR (p=0.03). In patients with intact disease, higher baseline StO2 associated with 24-month local control (p=0.02). CONCLUSIONS: Measurement of the physiologic properties of target lesions may allow for identification of patients with the highest probability of benefiting from PDT. This provides opportunity for optimizing light delivery based on lesion characteristics and/or informing ongoing clinical decision-making in patients who would most benefit from PDT.
BACKGROUND: We report on a Phase 1 trial of photodynamic therapy (PDT) for superficial head and neck (H&N) lesions. Due to known oxygen dependencies of PDT, translational measurements of lesion hemoglobin oxygen saturation (StO2) and blood volume (tHb) were studied for associations with patient outcomes. METHODS: PDT with aminolevulinc acid (ALA) and escalating light doses was evaluated for high-grade dysplasia, carcinoma-in-situ, and microinvasive carcinomas of the H&N. Among 29 evaluable patients, most (18) had lesions of the tongue or floor of mouth (FOM). Disease was intact in 18 patients and present at surgical margins in 11 patients. In 26 patients, lesion StO2 and tHb was measured. RESULTS: Local control (LC) at 24 months was 57.5% among all patients. In patients with tongue/FOM lesions LC was 42.7%, and it was 50.1% for those with intact lesions. Lesion tHb was not associated with 3-month complete response (CR), but StO2 was higher in patients with CR. In tongue/FOM lesions, baseline StO2 [mean(SE)] was 54(4)% in patients (n=12) with CR versus 23(8)% in patients (n=6) with local recurrence/persistence (p=0.01). Similarly, for intact disease, baseline StO2 was 54(3)% in patients (n=10) with CR versus 28(8)% in patients (n=5) without CR (p=0.03). In patients with intact disease, higher baseline StO2 associated with 24-month local control (p=0.02). CONCLUSIONS: Measurement of the physiologic properties of target lesions may allow for identification of patients with the highest probability of benefiting from PDT. This provides opportunity for optimizing light delivery based on lesion characteristics and/or informing ongoing clinical decision-making in patients who would most benefit from PDT.
Authors: A Amelink; O P Kaspers; H J C M Sterenborg; J E van der Wal; J L N Roodenburg; M J H Witjes Journal: Oral Oncol Date: 2007-03-09 Impact factor: 5.337
Authors: Peter H Ahn; Harry Quon; Bert W O'Malley; Gregory Weinstein; Ara Chalian; Kelly Malloy; Joshua H Atkins; Thomas Sollecito; Martin Greenberg; Sally McNulty; Alexander Lin; Timothy C Zhu; Jarod C Finlay; Keith Cengel; Virginia Livolsi; Michael Feldman; Rosemarie Mick; Theresa M Busch Journal: Oral Oncol Date: 2016-02-08 Impact factor: 5.337
Authors: John A Roque Iii; Houston D Cole; Patrick C Barrett; Liubov M Lifshits; Rachel O Hodges; Susy Kim; Gagan Deep; Antonio Francés-Monerris; Marta E Alberto; Colin G Cameron; Sherri A McFarland Journal: J Am Chem Soc Date: 2022-04-28 Impact factor: 16.383