Photodynamic Therapy Using Talaporfin Sodium for Local Failure after Chemoradiotherapy or Radiotherapy for Esophageal Cancer: A Single Center Experience

Abstract

A phase II study of second-generation photodynamic therapy (PDT) using talaporfin sodium has shown excellent treatment results for esophageal cancer with local failure after chemoradiotherapy (CRT) or radiotherapy (RT). However, only a few studies have reported this therapy in clinical practice. This study aimed to confirm the efficacy and safety of salvage PDT using talaporfin sodium for esophageal cancer in various clinical situations. Twelve patients with esophageal cancer with local failure after definitive CRT or RT who underwent PDT using talaporfin sodium were enrolled from April 2016 to January 2020. Overall, 10 patients (83.3%) achieved a local complete response. No skin phototoxicity was observed, but esophageal stricture occurred in five patients (41.7%). Esophageal stricture was improved with endoscopic balloon dilation in all patients, and subsequent analysis found no significant factors causing esophageal stricture after PDT. Two patients with synchronous tumors were successfully rescued by combination therapy with endoscopic submucosal dissection. Two patients with carcinoma in situ of larger than 1/2 circumference were rescued by repeated PDT. The 2-year overall survival was 80.0% (95% confidence interval 0.409–0.946). PDT using talaporfin sodium was an effective and safe salvage treatment for esophageal cancer with local failure after CRT or RT in various clinical situations.

Salvage treatment after definitive chemoradiotherapy for esophageal squamous cell carcinoma

“…68 Ishida et al reported an esophageal stricture rate of 41.7%. 68 Treatment-related death rates were 2.6% 59 and 1.8%. 67 Hatogai reported 5-year OS rates of 41.6% 59 and 36.9%, 67 and that cN status before dCRT was the only factor significantly associated with OS on multivariate analysis.…”

Targeted Photodynamic Diagnosis and Therapy for Esophageal Cancer: Potential Role of Functionalized Nanomedicine

“…Studies on PDT as salvage therapy for local failure following CRT on esophageal cancer have shown significant treatment improvements and survival outcomes. These studies reported complete response rates of 98.3% [18], 83.3% [19], and 58.4% [20]. Furthermore, the overall survival rates were 41.1% (5-year) and 80.0% (2-year) survival rates, respectively.…”

“…Talaporfin sodium is an efficient curative and salvage therapy for esophageal cancer with local failure following chemoradiotherapy without metastases. It has no adverse effect and is shown to improve the overall survival rate and patient quality of life; however, it is suboptimal for more extensive tumors [18,19,49,55].…”

Clinical Practice of Photodynamic Therapy Using Talaporfin Sodium for Esophageal Cancer

“…Minamide et al reported a retrospective comparative study between PDT u porfin sodium and porfimer sodium in patients with local failure after CRT [26]. complete response was better in patients treated with PDT using talaporfin sod pared with PDT using porfimer sodium (69.0% vs. 58.1%), although the differ After approval for clinical usage in Japan, PDT using talaporfin sodium followed by diode laser illumination for local failure after CRT or radiotherapy for esophageal cancer is gradually spreading, and there are several reports of the single-center experiences [24][25][26][27]. Minamide et al reported a retrospective comparative study between PDT using talaporfin sodium and porfimer sodium in patients with local failure after CRT [26].…”