Photodynamic therapy for the management of laryngeal malignancies

Carcinoma of the larynx accounts for 25-30% of all carcinomas of the head and neck [1]. Early carcinomas of the larynx (Cis, T1_, T2) and severe dysplasia are presently treated with either radiation therapy or surgery alone. Five-year cure rates achieved with this therapy is 75-90%. Radiation therapy has the advantage of preserving the physical integrity of the larynx, thereby preserving the voice. Radiation therapy, however, has significant disadvantages even when small laryngeal fields of radiation are used. These disadvantages include discomfort and mucositis during and for potential prolonged periods after therapy, permanently altered voice quality, dysphagia, chondroradionecrosis of the larynx and trachea, and the extensive length of therapy (6-7 weeks) [2, 3]. Surgical therapy for early carcinomas, that is, T1 and T2, of the larynx includes performing a partial cordectomy or hemilaryngectomy. Although cure rates are high, surgical removal of portions of the vocal cord or hemilarynx results in significant alteration of the quality of voice [4].