Journal of Dental Sciences
Volume 5, Issue 1 , Pages 36-40, March 2010

Successful treatment of an early invasive oral squamous cell carcinoma with topical 5-aminolevulinic acid-mediated photodynamic therapy

  • Hsin-Ming Chen

      Affiliations

    • Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
    • Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
    • Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
    • ,
  • Chuan-Hang Yu

      Affiliations

    • Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
    • ,
  • Hung-Pin Lin

      Affiliations

    • Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
    • ,
  • Hsiang Yang

      Affiliations

    • Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
    • ,
  • Ru-Cheng Kuo

      Affiliations

    • Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
    • ,
  • Ying-Shiung Kuo

      Affiliations

    • Department of Dentistry, Far Eastern Memorial Hospital, Taipei, Taiwan
    • ,
  • Chun-Pin Chiang

      Affiliations

    • Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
    • Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
    • Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Dentistry, National Taiwan University Hospital, 1, Chang-Te Street, Taipei 10048, Taiwan

Received 23 November 2009; accepted 21 January 2010.

Our previous studies showed successful treatment of a series of 36 oral verrucous hyperplasia lesions and of an extensive oral verrucous carcinoma with a topical 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (topical ALA-PDT) protocol (with a fluence rate of 100 mW/cm2 and a light exposure dose of 100 J/cm2) using a 635-nm light-emitting diode (LED) light source. In this case report, we tested whether an enhanced topical ALA-PDT protocol (with a fluence rate of 200 mW/cm2 and a light exposure dose of 200 J/cm2) could be used to treat an early invasive oral squamous cell carcinoma (OSCC) with a verrucous appearance of the left lower posterior edentulous alveolar mucosa of a 67-year-old male former areca-quid chewer and ex-smoker. The main verrucous lesion showed complete regression after eight treatments with PDT. However, 10 extra treatments were needed to eradicate the multiple residual leukoplakia lesions on the edentulous alveolar mucosa. Moderate to severe post-PDT pain was noted during the initial eight treatments, and the patient needed analgesics (codeine phosphate, 30 mg three times daily) to control the pain. No recurrence of the OSCC lesion was found after a follow-up period of 4 years. We suggest that our enhanced topical ALA-PDT protocol may have good potential to be used as a treatment of choice for a superficially invasive OSCC without regional or distant metastasis before the commencement of other effective therapies.

Key Words:  5-aminolevulinic acid , early invasive oral cancer , topical photodynamic therapy

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PII: S1991-7902(10)60006-2

doi:10.1016/S1991-7902(10)60006-2

Journal of Dental Sciences
Volume 5, Issue 1 , Pages 36-40, March 2010

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