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As salvage surgery after failure of chemoradiotherapy (CRT) for esophageal cancer shows high morbidity and mortality, curative and less invasive salvage treatment has been needed. Photodynamic therapy (PDT) is a candidate for local failure after CRT. Taraporfin sodium (Leserphyrin) is the new generation photosensitizer which was made in Japan, and has an advantage of low skin toxicity because of rapid clearance.
We conducted multi-institutional trial to evaluate the safety and efficacy of PDT using taraporfin sodium for patients with histologically proven local failure limited within the muscularis propria after 50Gy or more CRT for esophageal cancer. The PDT procedure commenced with intravenous administration of a 40mg/m2 dose of talaporfin sodium followed by diode laser irradiation at a 664nm wavelength. We set the primary endpoint as local complete response (L-CR) per patients. In this study, 26 patients were enrolled and all were treated with PDT. Twenty three patients were assessed L-CR after PDT; the L-CR rate per patient was 88.5 % (95% CI: 69.8%－97.6%). No skin phototoxicity was observed only with two weeks’ sun shade, and no grade 3 or worse non-hematological toxicities related to PDT were observed. At the timing of all enrolled cases were followed 3 years or longer, the median local progression free and overall survival time were 3.1 and 4.2 years, respectively.
PDT using new generation photosensitizer and a diode laser is a safe and potentially curative salvage treatment for local failure after CRT for patients with esophageal cancer.
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