Photodynamic Therapy for Early Esophageal Cancer

Abstract

Background/Aim: Although photodynamic therapy (PDT) has been used for the endoscopic treatment of digestive cancer, its curative efficacy remains uncertain. The aim of this study was to evaluate the curative role of PDT in early esophageal cancer. Methods: Nine patients with histologically proven early esophageal cancer (if surgery was contraindicated for old age (>80 years), poor surgical risk; Karnofsky performance status of at least 30%; refused operation) were injected with intravenous hematoporphyrin derivative (2 mg/kg) and PDT was performed 48 hours later. Response to treatment was assessed with gastroscopy with biopsies. Results: Mean follow-up time was 13.5 months (3.3∼34.3 months). According to TNM stage of endoscopic ultrasonography, T1 was 6, T2 was 3 cases. Complete remission (CR) to initial and consecutive PDT was observed in 8 cases. One case of failure was observed (This patient refused further treatment and was lost follow-up). Among CR cases, the recurrence rate was 12.5% (1/8), and time from initial PDT to recurrence was 117 days. Conclusion: PDT using hematoporphyrin derivative as the photosensitizser represents a safe and efficient method for treatment of early cancer. However, the study which requires long-term follow up period in large population is needed for confirmation. Key Words: Photodynamic therapy, Early esophageal cancer Table 2Characteristics of the patients and results from PDT Patient no Sex/Age EUS Histology Energy (J/cm2) Sessions of PDT Remission Follow up (months) Comments 1 M/70 T2 Squamous 120 1 CR 29 local recurrence 2 F/62 T1 Squamous 200 2 PR 4 RT 3 M/82 T1 Adenocarcinoma(P/D) 180 1 CR 13 E-G junction cancer 4 M/66 T1 Squamous 200 2 CR 4 5 M/68 T1 Squamous 180 1 CR 3 6 M/77 T1 Squamous 180 2 CR 29 7 M/64 T1 Squamous 160 2 CR 21.3 8 M/77 T2 Squamous 200 2 CR 5 9 M/68 T1 Squamous 180 1 CR 3 Open table in a new tab