RESUMO
Photodynamic therapy (PDT) is an innovative treatment involving the use of light-sensitive drugs to selectively identify and destroy diseased cells. Therefore, photodynamic therapy has the potential to treat and cure precancerous and early cancerous lesions (carcinoma in situ [CIS], T1 and T2) of the larynx while preserving normal tissue. Eleven patients with recurrent leukoplakia and carcinomas of the larynx were treated with PDT with follow-up to 27 months. One patient with a T1 verrucous carcinoma, 5 patients with T1 squamous cell carcinomas of the vocal cord failing radiotherapy, 1 patient with a T2 squamous cell carcinoma of the vocal cord failing radiotherapy, and 3 patients with CIS and severe atypia were treated with PDT and obtained a complete response and are disease free. One patient with a T3 carcinoma of the larynx was treated with PDT but died 4 weeks post-treatment of unrelated causes and could not be assessed. Photodynamic therapy is a promising therapy for treatment of precancerous and cancerous lesions of the larynx. This therapy may be particularly beneficial for the treatment of recurrent carcinomas of the larynx that have failed conventional radiotherapy, thereby preserving voice and eliminating the need for destructive laryngeal surgery.
Assuntos
Carcinoma in Situ/tratamento farmacológico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma Verrucoso/tratamento farmacológico , Neoplasias Laríngeas/tratamento farmacológico , Leucoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Fotoquimioterapia , Prega Vocal , Idoso , Idoso de 80 Anos ou mais , Carcinoma in Situ/diagnóstico por imagem , Carcinoma in Situ/patologia , Carcinoma in Situ/radioterapia , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/radioterapia , Carcinoma Verrucoso/diagnóstico por imagem , Carcinoma Verrucoso/patologia , Carcinoma Verrucoso/radioterapia , Terapia Combinada , Feminino , Seguimentos , Humanos , Neoplasias Laríngeas/diagnóstico por imagem , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/radioterapia , Leucoplasia/diagnóstico por imagem , Leucoplasia/patologia , Leucoplasia/radioterapia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/radioterapia , Estadiamento de Neoplasias , Indução de Remissão , Índice de Gravidade de Doença , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
The paper presents data of clinical and laboratory investigations performed in patients with vulvar leukoplakia or kraurosis before and after the helium-neon laser therapy. The impairment of adrenal performance (related to glucocorticoid, androgenic or mineralocorticoid functions) has been identified in the examinees. Employment of the laser therapy has normalized the impaired functions and beneficially affected local dystrophic processes in vulvar tissues. Local application of aerosol corticoid agents prolongs the response to the therapy.
