It has been reported that photodynamic therapy (PDT) is a very effective treatment for superficial oral malignancies, without affecting the adjacent normal tissue. In this paper, we describe the successful use of PDT for the treatment of early stage gingival carcinomas and report clinical outcomes.
The effect of PDT with a combination of Photofrin and Excimer dye lasers was evaluated for 16 lesions in 14 patients with superficial gingival squamous cell carcinomas. Each patient received Photofrin (2mg/kg) 48-60 hours befor photoradiation with 100-200 J/cm2 red laser light (630nm) delivered by an Excimer dye laser. The therapeutic efficacy was evaluated 4 weeks after PDT. Fifteen of the 16 lesions showed a complete response (93.8%), and the other lesion showed a partial response. Histological evaluation according to Ohoshi and Shimozato's classification revealed that 12 lesions were class IV b, and 4 were class II b. After at least 1 year of follow-up, 1 of 9 lesions showing a complete response had recurrence. There were no serious complications, except for skin photosensitivity reactions and sequestration of the alveolar ridge.
We conclude that PDT using Photofrin as a photosensitizer is an effective primary treatment for superficial gingival carcinomas, with excellent healing and minimal side effects.
