Salvage Photodynamic Therapy Is an Effective and Safe Treatment for Patients with Local Failure after Definitive Chemoradiotherapy for Esophageal Squamous Cell Carcinoma

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

Department of Experimental Therapeutics, Institute for Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital, Kyoto, Japan.
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Gastrointestinal Oncology, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan.
Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.

DOI: 10.4236/jct.2014.57073                

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.

Keywords

Esophageal Cancer, Salvage Treatment, Photodynamic Therapy, Chemoradiotherapy, Local Failure

Conflicts of Interest

The authors declare no conflicts of interest.

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