Long-term results of salvage photodynamic therapy for patients with local failure after chemoradiotherapy for esophageal squamous cell carcinoma

• DOI: 10.1055/s-0030-1256373
• Publication Date: 2011-05-27T21:01:22Z
• Authors: T. Yano; M. Muto; K. Minashi; M. Onozawa; K. Nihei; S. Ishikura; K. Kaneko; A. Ohtsu
• Keywords: Male; Salvage Therapy; Photosensitizing Agents; Time Factors; Esophageal Neoplasms; Lasers, Dye; Chemoradiotherapy; Kaplan-Meier Estimate; Middle Aged; Disease-Free Survival; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Photochemotherapy; Carcinoma, Squamous Cell; Humans; Dihematoporphyrin Ether; Female; Treatment Failure; Aged; Retrospective Studies

Local failure after chemoradiotherapy (CRT) remains a major problem for patients with esophageal squamous cell carcinoma (ESCC). The aim of this study was to clarify the long-term results of salvage photodynamic therapy (PDT) for local failure.Patients were treated with CRT, consisting of more than 50 Gy irradiation and concurrent chemotherapy. The indications for salvage PDT were as follows: 1) absence of lymph-node or distant metastasis after CRT; 2) failure lesion limited to T2; 3) refusal by patient to undergo salvage esophagectomy; 4) written informed consent. PDT was performed using an excimer dye laser at 48 and 72 hours after administration of Photofrin.A total of 37 consecutive patients underwent salvage PDT. The baseline stage before CRT was as follows: T1/T2/T3/T4 in 3/4/24/6 and N0/1 in 13/24 patients, respectively. Prior to PDT, 20 patients had a uT1 lesion, and 17 had a uT2 lesion; 24 patients had histologically proven local failure. A complete response was achieved in 22 patients (59.5%) following PDT. Esophageal fistulae, stenosis, and phototoxicity occurred in 4 (10.8%), 20 (54.1%), and 2 (5.4%) patients, respectively. Over a median follow-up period of 55 months, the 5-year progression-free (PFS) and overall survival rates of 37 patients following PDT were 20.7% and 36.1%, respectively. The 5-year PFS and overall survival of 24 patients with proven local failure were 17.6% and 34.6%, respectively.Salvage PDT is a curative treatment option for patients with local failure after CRT for ESCC.