In this study, doctors from the United States evaluated their experience using photodynamic therapy for the palliation of bleeding or obstructing esophageal cancer.
The team reviewed all patients who were treated with photodynamic therapy, between 1996 and 2002. A total of 215 patients received 318 courses of photodynamic therapy for bleeding (n = 15), obstruction (n = 277), bleeding and obstruction (n = 18), or other indications (n = 8).
Following Photofrin II injection, nonthermal light treatment was delivered endoscopically.
The team evaluated dysphagia scores, duration of palliation, reinterventions, complications, and survival after treatment.
|Dysphagia scores improved in 85% of obstruction cases.|
|Annals of Thoracic Surgery|
The doctors found that 75% of cancers occurred in the distal esophagus.
They determined that mean dysphagia scores improved in 85% of obstruction cases, and the mean dysphagia-free interval was 66 days.
The doctors were able to discontinue supplemental nutrition following treatment in 30% of 27 patients.
However, 35 patients required stent placement after photodynamic therapy.
The team found that complications included perforation (2%), stricture (2%), Candida esophagitis (2%), pleural effusions (4%), and sunburn (6%).
They determined that procedure-related mortality rate was 2%, and median survival was 4.8 months.
Dr Virginia Litle's team concluded, "Photodynamic therapy offers effective palliation for patients with obstructing esophageal cancer in 85% of treatment courses".
"The ideal esophageal cancer patient for photodynamic therapy palliation has an obstructing endoluminal cancer".
"Patients living more than 2 months may require reintervention to maintain palliation of malignant dysphagia, and a multimodality treatment approach is common".