TITLE:
Salvage Photodynamic Therapy Is an Effective and Safe Treatment for Patients with Local Failure after Definitive Chemoradiotherapy for Esophageal Squamous Cell Carcinoma
AUTHORS:
Yoko Mashimo, Yasumasa Ezoe, Kosuke Ueda, Yoshinao Ozaki, Yusuke Amanuma, Ikuo Aoyama, Takahiro Horimatsu, Shuko Morita, Shin’ichi Miyamoto, Tomonori Yano, Koji Higashino, Tsutomu Chiba, Manabu Muto
KEYWORDS:
Esophageal Cancer, Salvage Treatment, Photodynamic Therapy, Chemoradiotherapy, Local Failure
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.5 No.7,
June
3,
2014
ABSTRACT: Although chemoradiotherapy
(CRT) is one curative treatment option for patients with esophageal squamous
cell carcinoma (ESCC), local failure after CRT remains a major problem for
patients’ curability. The aim of this study was to evaluate the efficacy and safety
of photodynamic therapy (PDT) as a salvage treatment for local failure. From
August 2007 to March 2012, 193 consecutive ESCC patients were treated with
definitive CRT in Kyoto University Hospital. Eighteen of the patients with T2
or earlier T-stage local failure after CRT underwent salvage PDT. After the
salvage PDT, 11 patients (61.1%) achieved a complete response at the primary
site. Over a median follow-up period of 28.3 months, the 1-year survival and
progression-free survival rates were 77.8% and 38.9%, respectively; and the
2-year survival and progression-free survival rates were 60.6% and 33.3%,
respectively. Adverse events were mild esophageal stricture in seven (38.9%),
esophageal obstruction because of necrotic tissue in nine (50.0%), and photosensitivity
in three (16.7%) patients. There were no severe complications or
treatment-related deaths. Salvage PDT may be a promising treatment option for
the patients with a local residual or recurrent tumor after CRT for ESCC when
the lesion is suspected to be in T2 or earlier.