Postoperative photodynamic therapy as a new adjuvant treatment after robot-assisted salvage surgery of recurrent squamous cell carcinoma of the base of tongue

BACKGROUND For patients who remain with involved resection margins after transoral robot-assisted salvage surgery (TORS) for recurrent squamous cell carcinoma (SCC) at the base of tongue (BOT) following primary (chemo)radiotherapy, further adjuvant treatment options are very limited. We want to report on our preliminary experience with a new adjuvant strategy using postoperative temoporfin-mediated photodynamic therapy for this indication. METHODS Two patients with recurrent SCC after primary (chemo)radiotherapy of the BOT were treated with TORS, but unfortunately remained with involved resection margins on the postoperative pathology report. If left without additional treatment, these patients are prone to further recurrence. Temoporfin-mediated photodynamic therapy was used as a new adjuvant approach to treat the remaining microscopic disease at the resection margins. RESULTS Good oncological and functional results were obtained in these patients, now treated for a recurrence, after a preceding full course of radiotherapy. Both are disease free at 42 and 24 months of follow-up and are able to speak, breathe, and eat normally. CONCLUSIONS In selected patients that have undergone salvage surgery with positive resection margins, postoperative temoporfin-mediated photodynamic therapy can result in a good oncological and functional outcome.