Photodynamic therapy as salvage therapy for residual microscopic cancer after ultra-low anterior resection: A case report

Abstract

BACKGROUND The rate of positive resection margins (R1) in patients with low rectal cancer is substantial. Recommended remedies such as extended resection or chemoradiotherapy have their own serious drawbacks. It has been reported that photodynamic therapy (PDT) as a remedial treatment for esophageal cancer. Colorectal cancer and esophageal cancer has many similarities, however, PDT as a salvage therapy for rectal cancer is rare. CASE SUMMARY Here, we describe a 56-year-old man who was admitted to the hospital due to a 6-mo history of hemafecia, which had been aggravated for 1 mo. Colonoscopy revealed a 3 cm × 4 cm ulcerated mass in the rectum 4 cm from the anus. Preoperative pathological examination showed villous adenoma, moderate-to-high-grade dysplasia, good differentiation, and invasion of the mucosal muscle. The patient had R1 after ultra-low anterior resection, but he refused extended resection and experienced severe liver function impairment after 3 cycles of chemotherapy. Ultimately, the patient underwent PDT to remove R1. After five years of follow-up, there was no liver function impairment, recurrence, metastasis, sexual dysfunction, or abnormal defecation function. CONCLUSION This is the first case worldwide in which R1 of rectal cancer were successfully treated by PDT.

Photodynamic Therapy for Inflammatory and Cancerous Diseases of the Intestines: Molecular Mechanisms and Prospects for Application

“…Patients with CRLM, particularly those with diffuse liver metastases originating from CRC, frequently encounter unfavorable clinical outcomes, underscoring the necessity for the advancement of novel therapeutic approaches 40 . Promisingly, PDT exhibits substantial potential for application in CRLM 27 , 39 , 41 .…”

“…Importantly, PDT has been demonstrated to be a safe and effective treatment option for unresectable CRLM 152 . Furthermore, Zhang et al reported a successful case of PDT treatment for R1 rectal cancer 27 . Regrettably, there is currently a lack of available clinical research reports investigating the utilization of PDT for the treatment of IBD (Table 3 ).…”

“…Moreover, CAC patients tend to be diagnosed at a younger age compared to those with sporadic CRC, and their 5-year survival rate is 50% 24 . PDT, being one of the established pillars of cancer treatment, is recommended for various types of tumors 25 , and has proven to be an effective palliative treatment for advanced CRC 26 , 27 . Recent studies have provided evidence of PDT's ability to attenuate IBD through the downregulation of pro-inflammatory cytokines 7 , regulation of intestinal microbiota 18 , and modulation of miRNAs 16 .…”

Photodynamic Therapy for Colorectal Cancer: A Systematic Review of Clinical Research

“…After the removal of duplicate citations (310), 1341 citations were screened for relevance, of which 1289 were excluded. Of the remaining 52 studies that underwent full-text assessment for eligibility, 19 were ultimately included in the study [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] (see Figure 1).…”