Comparison between photodynamic therapy and interventional esophageal stent implantation in dysphagia caused by advanced esophageal cancer

Abstract

Objective: To compare the safety and efficacy of photodynamic therapy (PDT) and esophageal stent implantation in improving dysphagia caused by malignant obstruction of middle and advanced esophageal cancer. Methods: A total of 45 patients treated in the Affiliated Hospital of Qingdao University and Qingdao Huangdao District Central Hospital from January 2017 to January 2018 were retrospectively analyzed, of which 34 cases were males and 11 cases were females, 29 cases with the age beyond 60 years old, 41 cases were squamous carcinoma, 4 were adenocarcinoma. PDT was applied to 20 patients and 25 patients received esophageal carotid stenting implantation. There was no significant difference in gender, age, pathological type, location and stage between the two groups. Before treatment, 3 days, 1 month and 3 months after treatment, dysphagia was compared according to Stooler grading criteria, and also the time that patients experienced dysphagia again post treatment. Results: There were no statistical differences between the two groups in dysphagia grade change in 3 days, 1 month and 3 months after treatment (all P>0.05), The stent groups showed advantages towards the PDT group 3 days after treatment in patients with Stooler grading 0 (40%(10/25) vs 0(0/20), P<0.05). No significant differences were found between two groups with Stooler grading 0 (P>0.05) in 1 month and 3 months after treatment. Obstruction symptoms occurred earlier in the stent group compared with the PDT group (P<0.05). Conclusion: Esophageal stent can relieve the symptoms of dysphagia immediately after the implantation, while photodynamic therapy can also prolong the time of esophageal re-obstruction in addition to the immediate effect, with proved safety and efficacy in the treatment of middle and advanced esophageal cancer.