Salvage Photodynamic Therapy Using Talaporfin Sodium for Local Failure of Esophageal Squamous Cell Carcinoma

Abstract

Background Talaporfin sodium photodynamic therapy (TS-PDT) for local failure after chemoradiotherapy (CRT) in patients with esophageal squamous cell carcinoma has recently been reported to be highly effective and less invasive, compared to other treatment modalities. TS-PDT was recently introduced at the Tottori University Hospital, Japan. The aim of this study is to clarify the efficacy and safety of PDT in our hospital. Methods This was a single-center observational study. We examined eight cases of TS-PDT performed between January 2016 and December 2019. The main endpoints were local complete remission (L-CR) rate and the adverse events. In addition, age, gender, histology, tumor location, TNM stage, tumor depth, irradiation dose, and overall survival (OS) were examined. Results The patients included 7 men and a woman, with an average age of 72.1 years (range 63-82 years). The baseline clinical stages before CRT or radiotherapy were stage I in 1, stage II in 3, stage III in 3, and stage IVA in 1 patient. The T stage on endoscopic assessment before TS-PDT was T1 in 6 patients and T2 in 2 patients. Treatment outcomes and adverse events were evaluated. There were no treatment-related deaths, and no significant adverse events occurred intraoperatively or postoperatively. The L-CR rate was 7/8 (87.5%); T1 cases had 100% (6/6) L-CR, while T2 cases had 50% (1/2). The 2-year OS rates were 87%. Conclusion TS-PDT was observed to be safe and effective in the first eight cases of its application following its introduction in our hospital.

Clinical Impact of the Charlson Comorbidity Index on the Efficacy of Salvage Photodynamic Therapy Using Talaporfin Sodium for Esophageal Cancer

“…This preliminary retrospective study found that the CCI was negatively associated with the efficacy of salvage TS-PDT for esophageal cancer. We believe that this result has Intern Med Advance Publication DOI: 10.2169/internalmedicine.1907-23 (7,(15)(16)(17)(18). According to these studies, the L-CR rate ranged from 55.6% to 88.5%, and the likelihood of an L-CR was significantly affected by the clinical invasion depth of the tumor before PDT.…”

Rheumatoid Arthritis Symptoms Diagnosed by Rheumatic Immune-related Adverse Events Caused by Nivolumab in a Patient with Esophageal Cancer

“…The present patient received talaporfin sodium PDT (TS-PDT) for local recurrence after chemoradiotherapy (CRT) for esophageal cancer and achieved complete local remission. TS-PDT for local failure after CRT in patients with esophageal squamous cell carcinoma has recently been reported to be highly effective and less invasive than other treatment methods ( 11 , 12 ). However, our patient experienced lymph node metastasis approximately two years later, and nivolumab was administered.…”

Endoscopic Treatment for Disease Persistence/Recurrence after Definitive Chemoradiotherapy for Esophageal Cancer

“…In some studies, PDT has shown promising results in management of persistent or recurrent disease after initial treatment with chemoradiation therapy. 24,[29][30][31][32][33] In PDT, a photodynamic reaction is triggered by laser light on a photosensitizing drug that has an affinity for tumors. 46 PDT offers variable tissue penetration depending on the wavelength of the light source and the agent used.…”

“…Besides surgery and endoscopic resection, other salvage treatment modalities for lesions initially treated with CRT include photodynamic therapy (PDT), 24,29-33 radiofrequency ablation, and spray cryotherapy. We will now review salvage endoscopic therapy in more detail.…”

“…Furthermore, although there is abundant Asian literature on salvage therapy of esophageal squamous cancer after CRT, there is paucity of such literature from the West for esophageal adenocarcinoma. [16][17][18][19][20][21][22][23][24][25][26][27][28] Besides surgery and endoscopic resection, other salvage treatment modalities for lesions initially treated with CRT include photodynamic therapy (PDT), 24,[29][30][31][32][33] radiofrequency ablation, and spray cryotherapy. We will now review salvage endoscopic therapy in more detail.…”