Photodynamic therapy as salvage treatment for local failure after chemoradiotherapy in patients with esophageal squamous cell carcinoma: A phase II study
Open Access
- 25 October 2011
- journal article
- research article
- Published by Wiley in International Journal of Cancer
- Vol. 131 (5), 1228-1234
- https://doi.org/10.1002/ijc.27320
Abstract
Local failure at the primary site is a major problem after chemoradiotherapy (CRT) in patients with esophageal squamous cell carcinoma (ESCC). Salvage surgery is the only treatment option with curative intent, but it is associated with high morbidity and mortality. The aim of this study was to evaluate the efficacy and safety of salvage photodynamic therapy (PDT) after CRT. Patients with histologically proven local failure limited to the submucosal layer, and without any metastasis after definitive CRT (≥50 Gy) for ESCC were enrolled in the study. PDT began with intravenous administration of 2 mg/kg of porfimer sodium followed 48–72 hr later by excimer dye laser irradiation with a fluence of 75 J/cm2. The primary endpoint was a complete response (CR) to treatment with PDT, and the secondary endpoints were toxicity related to PDT, progression‐free survival (PFS) and overall survival (OS). Twenty‐five patients were enrolled in the study. A CR was attained in 19 of 25 patients treated with PDT (CR rate, 76%; 95% CI, 55–91%). One treatment‐related death (4%) caused by gastrointestinal hemorrhage at the irradiated site occurred 33 days after PDT. No adverse events greater than grade 3 were related to PDT in the other patients. After a median follow‐up of 48 months after PDT, the PFS and OS at 3 years were 40% (95% CI, 21–59%) and 38% (95% CI, 17–60%), respectively. PDT is a potentially curative and tolerable salvage treatment after CRT for carefully selected patients with local failure without any metastasis.Keywords
This publication has 20 references indexed in Scilit:
- Long-term results of salvage photodynamic therapy for patients with local failure after chemoradiotherapy for esophageal squamous cell carcinomaEndoscopy, 2011
- Submucosal tumor appearance is a useful endoscopic predictor of early primary-site recurrence after definitive chemoradiotherapy for esophageal squamous cell carcinomaDiseases of the Esophagus, 2010
- Elective nodal irradiation (ENI) in definitive chemoradiotherapy (CRT) for squamous cell carcinoma of the thoracic esophagusRadiotherapy and Oncology, 2009
- Salvage esophagectomy after definitive chemoradiotherapy for thoracic esophageal cancerJournal of Surgical Oncology, 2009
- Long-term results of salvage endoscopic mucosal resection in patients with local failure after definitive chemoradiotherapy for esophageal squamous cell carcinomaEndoscopy, 2008
- Oesophagectomy after Definitive Chemoradiation in Patients with Locally Advanced Oesophageal CancerClinical Oncology, 2008
- Salvage chemotherapy with mitomycin C, ifosfamide, and cisplatin (MIC) for previously treated metastatic or recurrent esophageal squamous cell carcinomaInvestigational New Drugs, 2008
- A phase II study of single-agent docetaxel in patients with metastatic esophageal cancerAnnals of Oncology, 2004
- Photodynamic Therapy of Early Squamous Cell Carcinomas of the Esophagus: A Review of 31 CasesEndoscopy, 1998
- Long-term survival after photodynamic therapy for esophageal cancerGastroenterology, 1995