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Advantages of salvage photodynamic therapy using talaporfin sodium for local failure after chemoradiotherapy or radiotherapy for esophageal cancer

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Abstract

Background

Photodynamic therapy (PDT) is a salvage treatment for local failure following chemoradiotherapy (CRT) for esophageal cancer. This study aimed to evaluate the efficacy and safety of salvage PDT using the second-generation photosensitizer, talaporfin sodium (L-PDT), and compare L-PDT to PDT using porfimer sodium (P-PDT).

Methods

We retrospectively analyzed clinical outcomes of patients treated with L-PDT and P-PDT. Patients with histologically proven local failure limited to the shallow muscularis propria layer (T2) after CRT or radiotherapy (RT) for esophageal cancer were enrolled.

Results

A total of 121 patients were enrolled in this study. L-PDT and P-PDT groups consisted of 44 and 77 patients, respectively. The overall local complete response (L-CR) rate was 62.1% (95% confidence interval [CI], 52.6–70.9), and the L-PDT group showed a better L-CR rate than did the P-PDT group (69.0% [95% CI 52.9–82.4] vs. 58.1% [95% CI 46.1–69.5]). The common complications of skin phototoxicity, esophageal stricture, and esophageal fistula were all less frequent in the L-PDT group than in the P-PDT group. The only treatment-related death in this study was in the P-PDT group. With a median follow-up period of 15.8 months (interquartile range 7.1–37.4) in all 121 patients, overall survival rate at 1 year was significantly higher among patients who achieved L-CR (91.2% [95% CI 80.2–96.3]) than among those who could not achieve L-CR with PDT (50.8% [95% CI 33.6–65.6]).

Conclusions

L-PDT represented better short-term outcomes than P-PDT as a salvage treatment for local failure following CRT or RT for esophageal cancer.

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Acknowledgments

We are grateful to our medical and nursing colleagues for their help.

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Authors and Affiliations

  1. Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Tatsunori Minamide, Yusuke Yoda, Keisuke Hori, Kensuke Shinmura, Yasuhiro Oono, Hiroaki Ikematsu & Tomonori Yano

Authors
  1. Tatsunori Minamide
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  2. Yusuke Yoda
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  3. Keisuke Hori
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  4. Kensuke Shinmura
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  5. Yasuhiro Oono
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  6. Hiroaki Ikematsu
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  7. Tomonori Yano
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Contributions

TM, TY—conception and design of the study. TM, YY, TY—Analysis and interpretation of data. TM—Drafting of the article. TY—Critical revision of the article for important intellectual content. YY, KH, KS, YO, HI, TY—Final approval of the article.

Corresponding author

Correspondence to Tomonori Yano.

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Disclosures

Drs Tatsunori Minamide, Yusuke Yoda, Keisuke Hori, Kensuke Shinmura, Yasuhiro Oono, Hiroaki Ikematsu, and Tomonori Yano have no conflict of interest or financial ties to disclose.

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Minamide, T., Yoda, Y., Hori, K. et al. Advantages of salvage photodynamic therapy using talaporfin sodium for local failure after chemoradiotherapy or radiotherapy for esophageal cancer. Surg Endosc 34, 899–906 (2020). https://doi.org/10.1007/s00464-019-06846-3

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