Gut Liver.  2007 Dec;1(2):126-131.

Outcome of Photodynamic Therapy for Early Esophageal Cancer

• Cheon YK
• Kim WJ
• Cho JY
• Lee JS
• Lee MS
• Shim CS

Abstract

BACKGROUND/AIMS: Endoscopic treatment as an alternative to surgery has become increasingly popular for improving the quality of life. Although photodynamic therapy (PDT) has been used for the endoscopic treatment of digestive cancer, its curative efficacy remains unclear. We evaluated the curative efficacy of PDT in superficial esophageal cancer in inoperable patients.
METHODS
Ten male patients with histologically proven early esophageal cancer (surgery was contraindicated for age > 80 years, surgery was contraindicated, Karnofsky performance status of at least 30%, or refusal of surgery) were intravenously injected with a hematoporphyrin derivative (2 mg/kg), and PDT was performed 48 h later. The response to treatment was assessed by gastroscopy with biopsies.
RESULTS
The mean follow-up period was 27.6 months (range, 9.6-58.7 months). Endoscopic ultrasonography revealed that all ten cases were at tumor stage T1. Complete remission (CR) to initial and subsequent PDT was observed in all patients. For the CR cases, the recurrence rate was 10% (1/10) and the time from initial PDT to recurrence was 9.6 months.
CONCLUSIONS
For patients in whom surgery is risky or refused, PDT may represent an acceptable alternative treatment modality, especially for superficial esophageal cancer without lymph node metastasis. However, a study involving long-term follow-up in a large population is needed for confirmation.

Keyword

Photodynamic therapy; Endoscopic treatment; Early esophageal cancer; Hematoporphyrin

MeSH Terms

Biopsy
Disulfiram
Endosonography
Esophageal Neoplasms*
Follow-Up Studies
Gastroscopy
Hematoporphyrin Derivative
Hematoporphyrins
Humans
Karnofsky Performance Status
Lymph Nodes
Male
Neoplasm Metastasis
Photochemotherapy*
Quality of Life
Recurrence
Disulfiram
Hematoporphyrin Derivative
Hematoporphyrins