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Pulsed potassium-titanyl-phosphate laser photoangiolytic treatment of mucosal squamous cell carcinoma in the hamster cheek pouch

Authors

  • James A. Burns MD, FACS,

    Corresponding author
    1. Department of Surgery , Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts
    • Assistant Professor, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, One Bowdoin Square, 11th Floor, Boston, MA 02114
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  • Gerardo Lopez-Guerra MD,

    1. Department of Surgery , Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts
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  • James B. Kobler PhD,

    1. Department of Surgery , Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts
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  • William Faquin MD,

    1. Department of Pathology , Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts
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  • Matthew LeClair BA,

    1. Harvard University , Cambridge, Massachusetts, U.S.A.
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  • Steven M. Zeitels MD, FACS

    1. Department of Surgery , Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts
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  • Presented at the Combined Sections Meeting of the Triological Society, Scottsdale, Arizona, U.S.A., January 29, 2011.

  • This work was supported by CIMIT under U.S. Army Medical Research Acquisition Activity Cooperative Agreement W81XWH-07-2-0011. The information contained herein does not necessarily reflect the position or policy of the Government, and no official endorsement should be inferred. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

Early glottic cancer has been involuted by treatment with the 532 nm pulsed potassium-titanyl-phosphate (KTP) laser in initial clinical studies. Selective photoangiolysis of the sublesional circulation that allows for relative sparing of surrounding tissue is the presumed mechanism. No prior controlled animal-model study has analyzed the ability of selective coagulation of lesional microvasculature coagulation with the KTP laser to involute malignant lesions. This study tests the efficacy of photoangiolysis with the KTP laser in treating squamous cell carcinoma in an established animal model.

Study Design:

In vivo.

Methods:

Malignant lesions were induced unilaterally in the cheek pouches of 21 hamsters by applying 9,10-dimethyl-1,2-benzanthrancene. The contralateral cheek pouch served as a control. Weekly lesion photodocumentation and pulsed KTP laser (30 W, 15 msec pulse width, 2 pulses/sec) treatments were done. The endpoint of each treatment was a uniform white-blanching of the lesion. Hamsters were sacrificed 1 week after the last treatment and cheek pouches were analyzed histologically.

Results:

Carcinoma was confirmed in 19 hamsters, and lesions that were initially <2 mm were more effectively treated than lesions that were >2 mm (P = .0004). Every lesion (10/10) that initially measured <2 mm resolved completely after laser treatment with minimal scarring noted at the treatment site based on histology. Lesions measuring between 2 and 5 mm resolved 33% of the time (2/6), and none (0/3) of the lesions >5 mm resolved after completion of the treatment period.

Conclusions:

Pulsed KTP laser photoangiolysis can effectively involute small malignant lesions, but may be less effective at involuting larger (>2 mm) lesions.

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