食道癌治療へのPDTの効用

抄録

An effectiveness of photodynamic therapy (PDT) using Hematoporphyrin Derivative (HpD) and Argon-dye or Excimer dye laser for the superficial esophageal carcinoma which cannot be treated by any surgical procedure because of the severe complications was reported.
Laser beam (630nm) has been endoscopically irradiated on the lesions 48 hours after an injecion of HpD with the power of 90-100 joule per 1 cm2.
PDT under this condition has been performed on 17 cases with the superficial esophagealcancer (17 lesions). The esophageal cancer in 12 cases of them has been radically treated in the first PDT, because biopsy specimens obtained endoscopically from the lesions have not proved malignancy more than one year and half. In 2 cases, a local remnant of the cancer was recognized and the remnant cancers were completely removed after the second PDT. Four cases were died from; pneumonia, advanced cancer of the other organ respectively and lymphnode metastasis of the esophageal cancer in 2 cases. In the cases in which the local remnant of the cancer was detected in the biopsy specimens after the first PDT, the size of their lesions was more than 4 cm2. The fetal complications were never observed, but sunburn due to the photosensitive reaction was found after the sun exposure.
Therefore, PDT is considered to be an excellent treatment for the superficial esophageal cancer less than 4 cm2 without lymphnode metastasis in the inoperable cases.