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November 1986

Porphyrin Fluorescence and Photosensitization in Head and Neck Cancer

Author Affiliations

From the Department of Otolaryngology-Head and Neck Surgery, University of Illinois College of Medicine at Chicago (Drs Harris, Hill, Werkhaven, and Applebaum); the Wenske Laser Center, Ravenswood Hospital Medical Center, Chicago (Drs Harris, Hill, Lobraico, and Waldow); and the Department of Surgery, West Side Veterans Administration Medical Center, Chicago (Drs Hill and Applebaum).

Arch Otolaryngol Head Neck Surg. 1986;112(11):1194-1199. doi:10.1001/archotol.1986.03780110070010

• Indistinct margin demarcation and autofluorescence are problems in fluorescence delineation of porphyrin-containing head and neck squamous cell cancer (HNSCC). We studied the time course and in vivo localization of porphyrin fluorescence in a squamous cell cancer hamster model and in human HNSCC. After intravenous injection, a gradient in fluorescence intensity developed rapidly until tumors fluoresced above a lower-intensity mucosal background. Hamster tumor and ulcerated HNSCC without porphyrin injection demonstrated autofluorescence grossly indistinguishable from fluorescence in porphyrin-injected tumors. However, fluorescence microscopy revealed autofluorescence to be a surface phenomenon and showed injected porphyrin localized in tumor stroma. We conclude that autofluorescence must be considered when interpreting porphyrin fluorescence. In addition, empirically designed photodynamic therapy can be effective in selected HNSCC. Data from animal experiments provide useful guidelines for the delivery of this therapy.

(Arch Otolaryngol Head Neck Surg 1986;112:1194-1199)