Salvage PDT for local failure after definitive chemoradiotherapy for esophageal cancer

Abstract

Background: We conducted an investigator initiated trial to evaluate the efficacy and safety of Laserphyrin-based PDT as a salvage treatment after chemoradiotherapy (CRT) or radiotherapy (RT) for EC. Methods: Patients with histologically proven local failure limited to the T2 after definitive CRT or RT (≥50 Gy) for EC were enrolled. PDT began with intravenous administration of 20 mg/kg of Laserphyrin followed 4-6 hrs later by a diode laser irradiation with a fluence of 100 J/cm2. The primary endpoint was a complete response (CR) of the primary site, and the secondary endpoints were PDT related toxicities. Results: 26 patients were enrolled. 18 cases were estimated as T1b and 8 cases were T2 by EUS. 23 cases achieved CR at primary site (CR rate: 88. 5%). Toxicity was acceptable. Conclusions: Laserphyrin-based PDT is a safe and potentially curative salvage treatment for local failure after CRT or RT for EC.