Abstract
Esophageal cancer is often diagnosed at the late stage when cancer has already spread and is characterized by a poor prognosis. Therefore, early diagnosis is vital for a better and efficient treatment outcome. Upper endoscopy with biopsy is the standard diagnostic tool for esophageal cancer but is challenging to diagnose at its premalignant stage, while conventional treatments such as surgery, chemotherapy, and irradiation therapy, are challenging to eliminate the tumor. Photodynamic diagnosis (PDD) and therapy (PDT) modalities that employ photosensitizers (PSs) are emerging diagnostic and therapeutic strategies for esophageal cancer. However, some flaws associated with the classic PSs have limited their clinical applications. Functionalized nanomedicine has emerged as a potential drug delivery system to enhance PS drug biodistribution and cellular internalization. The conjugation of PSs with functionalized nanomedicine enables increased localization within esophageal cancer cells due to improved solubility and stability in blood circulation. This review highlights PS drugs used for PDD and PDT for esophageal cancer. In addition, it focuses on the various functionalized nanomedicine explored for esophageal cancer and their role in targeted PDD and PDT for diagnosis and treatment.
Highlights
Esophageal cancer is ranked as the eighth most lethal neoplastic disease by incidence and the sixth cause of cancer-associated death globally, with a 5-year survival rate lower than 20%
Though photodynamic therapy (PDT) is associated with esophageal fistula and stricture, these findings show that PDT is a promising treatment alternative when cancer relapse has not extended beyond the T1-2 stage
5-aminolevulinic acid (5-ALA) has been employed for Photodynamic diagnosis (PDD) of various cancers such as bladder cancer [35], gastric cancer [36], and malignant glioma [37], as well as in esophageal cancer; this is due to its ability to fluorescence when activated within the visible blue and red light wavelength
Summary
Esophageal cancer is ranked as the eighth most lethal neoplastic disease by incidence and the sixth cause of cancer-associated death globally, with a 5-year survival rate lower than 20%. Esophageal cancer can be categorized into two types: esophageal squamous cell carcinoma (OSCC) and esophageal adenocarcinoma (OAC) [2]. These two cancer types are epidemiologically and histologically different. Esophageal squamous cell carcinoma is the most prevalent type of esophageal cancer, and it represents a 90% incidence of esophageal cancer worldwide. This cancer type has a high incidence rate in Asia, Africa, and South America.
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