POTENSI FOTODINAMIK SEBAGAI MODALITAS TERAPI ALTERNATIF NON INVASIF PADA ORAL CANCER
TINJAUAN EFIKASI DAN PROFIL KEAMANAN
Abstrak
Pendahuluan: Oral cancer didefinisikan sebagai keganasan yang terjadi pada kavitas oral dan kini menempati 10 besar penyebab kanker tertinggi sedunia. Tingkat mortalitas oral cancer masih tinggi dengan five-year survival rate hanya mencapai 50-60%. Tatalaksana saat ini bersifat invasif, berisiko tinggi, dengan berbagai efek samping yang berpotensi tinggi mengurangi efektivitas terapi hingga quality of life pasien. Berdasarkan studi terdahulu, fotodinamik merupakan modalitas terapi alternatif oral cancer yang menjanjikan karena bersifat selektif dan non invasif dengan efikasi serta outcome klinis yang baik. Metode: Tinjauan pustaka dibuat dengan kriteria PICO dari studi klinis yang memenuhi kriteria inklusi. Studi diekstraksi dari database “PubMed”, “ScienceDirect”, dan “SpringerLink” menggunakan metode pencarian “boolean operator”. Hasil & Pembahasan: Terdapat total 11 studi klinis yang memenuhi kriteria inklusi dan menyatakan terapi fotodinamik efektif dalam tatalaksana oral cancer. Efikasi klinis dilihat dari tingkat complete response dan survival rate yang baik disertai tingkat rekurensi yang rendah. Mekanisme yang melatarbelakangi efikasi yakni eksitasi photosensitizer memicu produksi reactive oxygen species yang mengakibatkan destruksi sel kanker. Selain itu juga ditemukan paparan fotodinamik dapat menyebabkan shut-down pembuluh darah jaringan tumor dan aktivasi sistem imun. Efek samping yang paling umum ditemukan adalah nyeri, pembengkakan, dan fotosensitivitas. Secara garis besar, efek samping tidak bersifat fatal, dapat dikendalikan dan tidak menyebabkan dampak fungsional maupun estetik yang persisten. Kesimpulan: Fotodinamik efektif sebagai modalitas terapi alternatif non invasif pada oral cancer dengan efikasi klinis dan profil keamanan yang baik.
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Referensi
2. Minić I, Pejčić A. Oral Cancer: Incidence and Management. J Oral Cancer Res. 2018;2(1):23.
3. International Agency for Research on Cancer. Indonesia-Global Cancer Observatory. Globocan 2020. 2021;858:1-2.
4. Speight PM, Farthing PM. The pathology of oral cancer. British dental journal. 2018 Nov;225(9):841.
5. Golusiński W, Kubiak A, Trojanowski M, Korytowska A, Pietrysiak A, Manasterski J, Pychyński T, Golusiński P, Majchrzak E, Sówka M, Szewczyk M. National Programme for Prevention and Early Detection of Head and Neck Cancer. Otolaryngologia polska= The Polish otolaryngology. 2015 Jan 1;69(4):7-12.
6. Kumar M, Nanavati R, Modi TG, Dobariya C. Oral cancer: Etiology and risk factors: A review. Journal of cancer research and therapeutics. 2016 Apr 1;12(2):458-63
7. Ikeda H, Ohba S, Egashira K, Asahina I. The effect of photodynamic therapy with talaporfin sodium, a second-generation photosensitizer, on oral squamous cell carcinoma: A series of eight cases. Photodiagnosis and photodynamic therapy. 2018 Mar 1;21:176-80
8. Wong TS, Wiesenfeld D. Oral cancer. Australian dental journal. 2018 Mar;63:S91-9.
9. Shanti RM, O'Malley Jr BW. Surgical Management of Oral Cancer. Dental Clinics of North America. 2017 Oct 16;62(1):77-86.
10. Ikeda H, Tobita T, Ohba S, Uehara M, Asahina I. Treatment outcome of Photofrin-based photodynamic therapy for T1 and T2 oral squamous cell carcinoma and dysplasia. Photodiagnosis and photodynamic therapy. 2013 Sep 1;10(3):229-35.
11. Liu YQ, Wang XL, He DH, Cheng YX. Protection against chemotherapy-and radiotherapy-induced side effects: A review based on the mechanisms and therapeutic opportunities of phytochemicals. Phytomedicine. 2020 Oct 31:153402
12. Jerjes W, Upile T, Hamdoon Z, Mosse CA, Akram S, Hopper C. Photodynamic therapy outcome for oral dysplasia. Lasers in surgery and medicine. 2011 Mar;43(3):192-9.
13. Karakullukcu B, van Oudenaarde K, Copper MP, Klop WM, van Veen R, Wildeman M, Tan IB. Photodynamic therapy of early stage oral cavity and oropharynx neoplasms: an outcome analysis of 170 patients. European Archives of Oto-Rhino-Laryngology. 2011 Feb;268(2):281-8.
14. Karakullukcu B, Nyst HJ, van Veen RL, Hoebers FJ, Hamming–Vrieze O, Witjes MJ, de Visscher SA, Burlage FR, Levendag PC, Sterenborg HJ, Tan IB. mTHPC mediated interstitial photodynamic therapy of recurrent nonmetastatic base of tongue cancers: Development of a new method. Head & neck. 2012 Nov;34(11):1597-606.
15. de Visscher SA, Melchers LJ, Dijkstra PU, Karakullukcu B, Tan IB, Hopper C, Roodenburg JL, Witjes MJ. mTHPC-mediated photodynamic therapy of early stage oral squamous cell carcinoma: a comparison to surgical treatment. Annals of surgical oncology. 2013 Sep;20(9):3076-82.
16. Jerjes W, Upile T, Hamdoon Z, Alexander Mosse C, Morcos M, Hopper C. Photodynamic therapy outcome for T1/T2 N0 oral squamous cell carcinoma. Lasers in surgery and medicine. 2011 Aug;43(6):463-9.
17. Karakullukcu B, Stoker SD, Wildeman AP, Copper MP, Wildeman MA, Tan IB. A matched cohort comparison of mTHPC-mediated photodynamic therapy and trans-oral surgery of early stage oral cavity squamous cell cancer. European Archives of Oto-Rhino-Laryngology. 2013 Mar;270(3):1093-7.
18. Durbec M, Cosmidis A, Fuchsmann C, Ramade A, Céruse P. Efficacy and safety of photodynamic therapy with temoporfin in curative treatment of recurrent carcinoma of the oral cavity and oropharynx. European Archives of Oto-Rhino-Laryngology. 2013 Mar;270(4):1433-9.
19. Toratani S, Tani R, Kanda T, Koizumi K, Yoshioka Y, Okamoto T. Photodynamic therapy using Photofrin and excimer dye laser treatment for superficial oral squamous cell carcinomas with long-term follow up. Photodiagnosis and photodynamic therapy. 2016 Jun 1;14:104-10.
20. Rigual N, Shafirstein G, Cooper MT, Baumann H, Bellnier DA, Sunar U, Tracy EC, Rohrbach DJ, Wilding G, Tan W, Sullivan M. Photodynamic therapy with 3-(1′-hexyloxyethyl) pyropheophorbide a for cancer of the oral cavity. Clinical Cancer Research. 2013 Dec 1;19(23):6605-13.
21. Agostinis P, Berg K, Cengel KA, Foster TH, Girotti AW, Gollnick SO, Hahn SM, Hamblin MR, Juzeniene A, Kessel D, Korbelik M. Photodynamic therapy of cancer: an update. CA: a cancer journal for clinicians. 2011 Jul;61(4):250-81.
22. Lin J, Ni G, Ding T, Lei S, Zhong L, Liu N, Pan K, Chen T, Zeng X, Xu H, Li T. Photodynamic Therapy for Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. International Journal of Photoenergy. 2021 Feb 16;2021.
23. Sai DL, Lee J, Nguyen DL, Kim YP. Tailoring photosensitive ROS for advanced photodynamic therapy. Experimental & Molecular Medicine. 2021 Apr;53(4):495-504.
24. dos Santos AF, de Almeida DR, Terra LF, Baptista MS, Labriola L. Photodynamic therapy in cancer treatment-an update review. Journal of cancer metastasis and treatment. 2019 Mar 29;5.
25. Benov L. Photodynamic therapy: current status and future directions. Medical Principles and Practice. 2015;24(Suppl. 1):14-28.
26. Hamblin MR. Upconversion in photodynamic therapy: plumbing the depths. Dalton Transactions. 2018;47(26):8571-80
27. Mroz P, Yaroslavsky A, Kharkwal GB, Hamblin MR. Cell death pathways in photodynamic therapy of cancer. Cancers. 2011 Jun;3(2):2516-39.
28. Miki,Y.,Akimoto,J.,Moritake,K.,Hironaka,C.&Fujiwara,Y.Photodynamictherapy using talaporfin sodium induces concentration-dependent pro-grammed necroptosis in human glioblastoma T98G cells.Lasers Med. Sci.30,1739–1745 (2015)
29. Hou YJ, Yang XX, Liu RQ, Zhao D, Guo CX, Zhu AC, Wen MN, Liu Z, Qu GF, Meng HX. Pathological Mechanism of Photodynamic Therapy and Photothermal Therapy Based on Nanoparticles. International Journal of Nanomedicine. 2020;15:6827.
