Photodynamic therapy for esophageal cancer

Abstract

Photodynamic therapy (PDT) is a treatment that uses a photosensitizing drug that is administered to the patient, localized to a tumor, and then activated with a laser to induce a photochemical reaction to destroy the cell. PDT using porfimer sodium followed by excimer dye laser irradiation is approved as a curative treatment for superficial esophageal cancer in Japan. While endoscopic submucosal dissection (ESD) is currently more popular for esophageal cancer, there is evidence to support PDT as an alternative treatment and as a salvage treatment for local failure after chemoradiotherapy (CRT). A photosensitizing agent has also been developed that requires a shorter sun shade period after administration, and studies are currently underway to establish an esophageal cancer indication for this next-generation PDT in Japan.

Keywords: Esophageal cancer; photodynamic therapy (PDT); salvage therapy.

Figure 1

A case with local failure after CRT was treated with salvage photodynamic therapy (PDT). (A) a local failure lesion limited to within T1b; (B) a lesion was well demarcated after Lugol’s staining; (C) deep ulceration was present one week after PDT; (D) complete response (CR) was achieved and continued one year after PDT.