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Proceedings Paper

Photodynamic therapy as an alternative treatment modality for early stage buccal mucosa malignancy (Conference Presentation)

Paper Abstract

Oral cancers are the 8th most common cancer among males. In India, this corresponds to almost 80,000 new cases per year. With such a disease burden, oral cancers are a prime cause of morbidity and functional disability. Conventional treatment for oral cancers is surgery and radiation therapy which are fraught with physical and functional side effects, and the high cost and infrastructure requirements present barriers to timely intervention for patients in rural and/or resource-limited areas. Motivated by these considerations we sought to evaluate photodynamic therapy (PDT) as an approach which is inherently conducive to adaptation for resource-limited settings and has previously shown promising clinical results for early stage oral lesions. In this study we evaluate a low-cost platform for aminolevulinic acid (ALA)-based PDT consisting of a portable 635nm fiber-coupled LED light source integrated with 3D printed applicators for stable intraoral light delivery and smartphone-based fluorescence imaging for treatment guidance. Using this technology, we treated 18 subjects with histologically confirmed T1N0M0 lesions of the buccal mucosa with a mean diameter of 1.38 cm2 and micro-invasive (≤ 5mm depth) disease. A total light dose of 100 J/cm2 was delivered in 3 to 5 fractions to the buccal mucosa after oral administration of 60mg/kg ALA (in 3 aliquots of 20mg/kg). The post-PDT investigations showed a 72% success rate (no residual malignancy in follow-up biopsy). The treatment was very well tolerated and has potential for broader dissemination into primary care sites and as an early intervention for pre-malignant conditions including submucous fibrosis and leucoplakia.

Paper Details

Date Published: 14 August 2019
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Proc. SPIE 11070, 17th International Photodynamic Association World Congress, 1107053 (14 August 2019); doi: 10.1117/12.2525686
Show Author Affiliations
Shahid Ali Siddiqui, Jawaharlal Nehru Medical College (India)
M. A. Bilal Hussain, Jawaharlal Nehru Medical College (India)
Amjad P. Khan, Wellman Ctr. for Photomedicine (United States)
Massachusetts General Hospital (United States)
Harvard Medical School (United States)
Kafil Akhtar, Jawaharlal Nehru Medical College (India)
Shaista Siddiqui, Jawaharlal Nehru Medical College (India)
Shakir Khan, Jawaharlal Nehru Medical College (India)
Hui Liu, Univ. of Massachusetts Boston (United States)
Srivalleesha Mallidi, Wellman Ctr. for Photomedicine (United States)
Massachusetts General Hospital (United States)
Harvard School of Medicine (United States)
Grant Rudd, Univ. of Massachusetts Boston (United States)
Liam Daly, Univ. of Massachusetts Boston (United States)
Paola L. Alacron, Univ. of Massachusetts Boston (United States)
Filip Cuckov, Univ. of Massachusetts Boston (United States)
Satish C. Sharma, Jawaharlal Nehru Medical College (India)
Ibne Ahmed, Jawaharlal Nehru Medical College (India)
Stephen G. Bown, Univ. College London (United Kingdom)
Colin Hopper, Univ. College London (United Kingdom)
Jonathan P. Celli, Univ. of Massachusetts Boston (United States)
Syed Abrar Hasan, Jawaharlal Nehru Medical College (India)
Tayyaba Hasan, Wellman Ctr. for Photomedicine (United States)
Massachusetts General Hospital (United States)
Harvard Medical School (United States)


Published in SPIE Proceedings Vol. 11070:
17th International Photodynamic Association World Congress
Tayyaba Hasan, Editor(s)

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