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

• 作者: Ikuo Aoyama Koji Higashino Kosuke Ueda Manabu Muto Shin’ichi Miyamoto Shuko Morita Takahiro Horimatsu Tomonori Yano Tsutomu Chiba Yasumasa Ezoe Yoko Mashimo Yoshinao Ozaki Yusuke Amanuma
• 来源期刊: 癌症治疗(英文)
• 学科: 医学
• 关键词: ESOPHAGEAL Cancer SALVAGE TREATMENT Photodynamic Therapy CHEMORADIOTHERAPY Local Failure
• 年，卷（期）: 2014,（7）
• 页码范围: 647-656
• 页数: 10页
• 分类号: R73

摘要

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.