Repeated talaporfin sodium photodynamic therapy for esophageal cancer: safety and efficacy

Masashi Tamaoki,Yosuke Mitani,Akira Yokoyama,Takahiro Horimatsu,Hirokazu Higuchi,Manabu Muto,Shinya Ohashi,Kenshiro Hirohashi,Masahiro Yoshioka,Yusuke Amanuma

doi:10.1007/s10388-021-00853-x

Abstract

BackgroundTalaporfin sodium photodynamic therapy (tPDT) is an effective salvage treatment for local failure after chemoradiotherapy for esophageal cancer. Repeated tPDT could also be indicated for local recurrence or residue after the first salvage tPDT. However, the safety and efficacy of repeated tPDT have not been elucidated.MethodsWe reviewed 52 patients with esophageal cancer who were treated with the first tPDT at Kyoto University Hospital between October 2015 and April 2020.ResultsAmong 52 patients, repeated tPDT after the first tPDT was indicated for 13 patients (25%), of which six had residual tumor, four had local recurrence after complete response (CR) after the first tPDT at the primary site, and six had metachronous lesion. The total session of repeated tPDT was 25; 16 were for primary sites and nine were for metachronous sites. Among them, six patients (46.2%) achieved local (L)-CR and nine lesions (56.3%) achieved lesion L-CR. By session, 10 sessions (40%) achieved L-CR. There were no severe adverse events except for one patient; this patient showed grade 3 esophageal stenosis and perforation after the third tPDT on the same lesion that was previously treated with porfimer sodium photodynamic therapy four times.ConclusionRepeated tPDT could be an effective and safe treatment for local failure even after salvage tPDT for esophageal cancer.

Highlights

Esophageal cancer is the sixth most common cause of cancer-related deaths worldwide [1]
Three patients were treated with chemotherapy for other cancers. ****One patient who had a residual lesion after the first Talaporfin sodium photodynamic therapy (tPDT) was treated with APC followed by repeated tPDT. ***** One patient, who achieved L-complete response (CR) after the first tPDT, had intramural metastasis, and was treated with chemotherapy followed by repeated tPDT
In these 13 patients, 16 lesions were indicated for repeated tPDT, 10 lesions were at the primary site treated with the first tPDT, and six lesions were at the metachronous site (Fig. 3)

Summary

Introduction

Esophageal cancer is the sixth most common cause of cancer-related deaths worldwide [1]. Talaporfin sodium photodynamic therapy (tPDT) is an effective salvage treatment for local failure after chemoradiotherapy for esophageal cancer. Methods We reviewed 52 patients with esophageal cancer who were treated with the first tPDT at Kyoto University Hospital between October 2015 and April 2020. Results Among 52 patients, repeated tPDT after the first tPDT was indicated for 13 patients (25%), of which six had residual tumor, four had local recurrence after complete response (CR) after the first tPDT at the primary site, and six had metachronous lesion. There were no severe adverse events except for one patient; this patient showed grade 3 esophageal stenosis and perforation after the third tPDT on the same lesion that was previously treated with porfimer sodium photodynamic therapy four times. Conclusion Repeated tPDT could be an effective and safe treatment for local failure even after salvage tPDT for esophageal cancer

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