Initial experience in the treatment of oral leukoplakia with high-dose vitamin A and follow-up 5-aminolevulinic acid induced protoporphyrin IX fluorescence

TY - JOUR

T1 - Initial experience in the treatment of oral leukoplakia with high-dose vitamin A and follow-up 5-aminolevulinic acid induced protoporphyrin IX fluorescence

AU - Leunig, A

AU - Betz, CS

AU - Baumgartner, R

AU - Grevers, G

AU - Issing, WJ

PY - 2000/7/1

Y1 - 2000/7/1

N2 - The aim of photodynamic diagnostics is complete visualization of all neoplastic lesions in a tumorous organ after the application of a tumor-selective photosensitizer. We explored the potential benefit of a combination of retinyl palmitate for the treatment of oral leukoplakias and follow-up diagnosis of malignant tissue by using 5-aminolevulinic acid (5-ALA) as a fluorescence marker. Semiquantitative measurements were performed following the topical application of 5-ALA in six patients. After biopsy and histological evaluation of tissue specimens the patients were treated with escalating doses of retinyl palmitate. After treatment periods ranging from 4 to 8 weeks 5-ALA was again applied for photodetection of persisting fluorescence. In all cases prior to retinyl palmitate treatment a prominent red fluorescence indicated tissue dysplasia. Eight weeks after treatment with retinyl palmitate decreased red fluorescence intensities were found, and repeated histological evaluations showed no persistent signs of dysplastic lesions. Our initial experience shows that high doses of retinyl palmitate can be useful for treating dysplastic lesions in the upper aerodigestive tract and can be monitored with 5-ALA induced protoporphyrin IX fluorescence.

AB - The aim of photodynamic diagnostics is complete visualization of all neoplastic lesions in a tumorous organ after the application of a tumor-selective photosensitizer. We explored the potential benefit of a combination of retinyl palmitate for the treatment of oral leukoplakias and follow-up diagnosis of malignant tissue by using 5-aminolevulinic acid (5-ALA) as a fluorescence marker. Semiquantitative measurements were performed following the topical application of 5-ALA in six patients. After biopsy and histological evaluation of tissue specimens the patients were treated with escalating doses of retinyl palmitate. After treatment periods ranging from 4 to 8 weeks 5-ALA was again applied for photodetection of persisting fluorescence. In all cases prior to retinyl palmitate treatment a prominent red fluorescence indicated tissue dysplasia. Eight weeks after treatment with retinyl palmitate decreased red fluorescence intensities were found, and repeated histological evaluations showed no persistent signs of dysplastic lesions. Our initial experience shows that high doses of retinyl palmitate can be useful for treating dysplastic lesions in the upper aerodigestive tract and can be monitored with 5-ALA induced protoporphyrin IX fluorescence.

KW - leukoplakia

KW - retinyl palmitate treatment

KW - 5-aminolevulinic acid induced fluorescence

U2 - 10.1007/s004059900222

DO - 10.1007/s004059900222

M3 - SCORING: Journal article

VL - 257

SP - 327

EP - 331

JO - EUR ARCH OTO-RHINO-L

JF - EUR ARCH OTO-RHINO-L

SN - 0937-4477

IS - 6

ER -