Dr. Shigeru Hirano

Abstract:

Head and neck cancers occur in the oral cavity, pharynx, and larynx, which compromise several fundamental functions such as swallowing, voicing, respiration, and articulation. Advanced cancers are usually treated by radiotherapy or radical surgery, however, post-treatment QOL is often severely deteriorated. Photoimmunotherapy (PIT) is a innovative treatment that can kill cancers cells in pinpoint manner, preserving surrounding healthy tissues. PIT consists of systemic administration of antibody-photoabsorbance conjugate (APC) followed by irradiation of near infrared light. The tumor can be immediately diminished, and since the membrane of the cell is destroyed, neoantigen is emitted, which can lead to strengthening of cancer immune system. PIT is approved only in Japan now, but clinical trials are under way in manay countries. PIT also produces reactive oxygen speices (ROS) which may be effective for cancer treatment, but on the other hand, it is suggested that ROS may cause post-treatment laryngeal edema which occasionally requires tracheostomy. The edema can ocuur even without lightening to the larynx. It is important to correctly use PIT to have the best effects in mean time to avoid edema. Recent researches suggest that anti-oxidant can prevent the laryngeal edema without decreasing the therapeutic effects for cancer. The current status of PIT for head and neck caners is reported.