Skip to main content

Advertisement

SpringerLink
Log in

Combination of photodynamic therapy and endoscopic mucosal resection for recurrent esophageal squamous cell carcinoma after chemoradiotherapy

  • Case Report
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Photodynamic therapy (PDT) was developed for residual or recurrent esophageal cancer after radiotherapy. Here, we report a case of successful treatment of highly elevated esophageal squamous cell carcinoma (ESCC) that recurred after definitive chemoradiotherapy (dCRT) using PDT combined with endoscopic resection (ER). An 86-year-old man was found to have an ESCC in the mid-thoracic esophagus. One year and two months after dCRT, a local recurrence was seen. The recurrent ESCC had a highly elevated component. The ESCC was estimated to have invaded the deep submucosa at the highly elevated component. PDT was selected as a treatment option since no lymph node or distant metastases were found. However, there was concern that the laser would not be able to penetrate deep into the ESCC due to its high elevated component. Therefore, ER was performed to remove the highly elevated component, and PDT was performed later. However, after the ER, the circumference of the recurrent ESCC was found to be approximately half the circumference, and post-PDT stenosis was also a concern due to the wide circumference of the ESCC. Therefore, we limited the area of laser irradiation in one session of PDT. Four sessions of PDT were needed over 13 months, but a local complete response was achieved without adverse events.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Yamada K, Murakami M, Okamoto Y, et al. Treatment results of chemoradiotherapy for clinical stage I (T1N0M0) esophageal carcinoma. Int J Radiat Oncol Biol Phys. 2006;64:1106–11.

    Article  PubMed  Google Scholar 

  2. Kato H, Sato A, Fukuda H, et al. A phase II trial of chemoradiotherapy for stage I esophageal squamous cell carcinoma: Japan Clinical Oncology Group Study (JCOG9708). Jpn J Clin Oncol. 2009;398:638–43.

    Article  Google Scholar 

  3. Kato K, Muro K, Minashi K, et al. Phase II study of chemoradiotherapy with 5-fluorouracil and cisplatin for Stage II–III esophageal squamous cell carcinoma: JCOG trial (JCOG 9906). Int J Radiat Oncol Biol Phys. 2011;81:684–90.

    Article  CAS  PubMed  Google Scholar 

  4. Versteijne E, van Laarhoven HW, van Hooft JE, et al. Definitive chemoradiation for patients with inoperable and/or unresectable esophageal cancer: locoregional recurrence pattern. Dis Esophagus. 2015;28:453–9.

    Article  CAS  PubMed  Google Scholar 

  5. Chen M, Liu P, Chen Y, et al. Primary tumor regression patterns in esophageal squamous cell cancer treated with definitive chemoradiotherapy and implications for surveillance schemes. Cancer Manag Res. 2019;11:3361–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Sudo K, Kato K, Kuwabara H, et al. Patterns of relapse after definitive chemotherapy in stage II/III (Non-T4) esophageal squamous cell carcinoma. Oncology. 2018;94:47–54.

    Article  CAS  PubMed  Google Scholar 

  7. Ishikura S, Nihei K, Ohtsu A, et al. Long-term toxicity after definitive chemoradiotherapy for squamous cell carcinoma of the thoracic esophagus. J Clin Oncol. 2003;21:2697–702.

    Article  CAS  PubMed  Google Scholar 

  8. Wang S, Tachimori Y, Hokamura N, et al. Prognostic analysis of salvage esophagectomy after definitive chemoradiotherapy for esophageal squamous cell carcinoma: the importance of lymphadenectomy. J Thorac Cardiovasc Surg. 2014;147:1805–11.

    Article  PubMed  Google Scholar 

  9. Chen Y, Lu Y, Wang Y, et al. Comparison of salvage chemoradiation versus salvage surgery for recurrent esophageal squamous cell carcinoma after definitive radiochemotherapy or radiotherapy alone. Dis Esophagus. 2014;27:134–40.

    Article  CAS  PubMed  Google Scholar 

  10. Tachimori Y, Kanamori N, Uemura N, et al. Salvage esophagectomy after high-dose chemoradiotherapy for esophageal squamous cell carcinoma. J Thorac Cardiovasc Surg. 2009;137:49–54.

    Article  PubMed  Google Scholar 

  11. Takeuchi M, Kobayashi M, Hashimoto S, et al. Salvage endoscopic submucosal dissection in patients with local failure after chemoradiotherapy for esophageal squamous cell carcinoma. Scand J Gastroenterol. 2013;48:1095–101.

    Article  CAS  PubMed  Google Scholar 

  12. Makazu M, Kato K, Takisawa H, et al. Feasibility of endoscopic mucosal resection as salvage treatment for patients with local failure after definitive chemoradiotherapy for stage IB, II, and III esophageal squamous cell cancer. Dis Esophagus Dis Esophagus. 2014;27:42–9.

    Article  CAS  PubMed  Google Scholar 

  13. Yano T, Muto M, Hattori S, et al. Long-term results of salvage endoscopic mucosal resection in patients with local failure after definitive chemoradiotherapy for esophageal squamous cell carcinoma. Endoscopy. 2008;40:717–21.

    Article  CAS  PubMed  Google Scholar 

  14. Matono S, Fujita H, Tanaka T, et al. Salvage lymphadenectomy without esophagectomy is an option for recurrent or residual lymph nodes after definitive chemoradiotherapy for esophageal cancer. Esophagus. 2014;11:197–203.

    Article  Google Scholar 

  15. Tomimaru Y, Yano M, Takachi K, et al. Factors affecting the prognosis of patients with esophageal cancer undergoing salvage surgery after definitive chemoradiotherapy. J Surg Oncol. 2006;93:422–8.

    Article  PubMed  Google Scholar 

  16. D’Journo XB, Michelet P, Dahan L, et al. Indications and outcome of salvage surgery for oesophageal cancer. Eur J Cardiothorac Surg. 2008;33:1117–23.

    Article  PubMed  Google Scholar 

  17. Nakamura T, Hayashi K, Ota M, et al. Salvage esophagectomy after definitive chemotherapy and radiotherapy for advanced esophageal cancer. Am J Surg. 2004;188:261–6.

    Article  PubMed  Google Scholar 

  18. Koizumi S, Jin M, Matsuhashi T, et al. Salvage endoscopic submucosal dissection for the esophagus-localized recurrence of esophageal squamous cell cancer after definitive chemoradiotherapy. Gastrointest Endosc. 2014;79:348–53.

    Article  PubMed  Google Scholar 

  19. Hatogai K, Yano T, Kojima T, et al. Local efficacy and survival outcome of salvage endoscopic therapy for local recurrent lesions after definitive chemoradiotherapy for esophageal cancer. Radiat Oncol. 2016;11:31.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Yano T, Kasai H, Horimatsu T, et al. A multicenter phase II study of salvage photodynamic therapy using talaporfin sodium (ME2906) and a diode laser (PNL6405EPG) for local failure after chemoradiotherapy or radiotherapy for esophageal cancer. Oncotarget. 2017;8:22135–44.

    Article  PubMed  Google Scholar 

  21. Yano T, Muto M, Minashi K, et al. Long-term results of salvage photodynamic therapy for patients with local failure after chemoradiotherapy for esophageal squamous cell carcinoma. Endoscopy. 2011;43:657–63.

    Article  CAS  PubMed  Google Scholar 

  22. Yano T, Muto M, Minashi K, et al. Photodynamic therapy as salvage treatment for local failure after chemoradiotherapy in patients with esophageal squamous cell carcinoma: a phase II study. Int J Cancer. 2012;131:1228–34.

    Article  CAS  PubMed  Google Scholar 

  23. Yano T, Wang KK. Photodynamic therapy for gastrointestinal cancer. Photochem Photobiol. 2020;96:517–23.

    Article  CAS  PubMed  Google Scholar 

  24. Yano T, Minamide T, Takashima K, et al. Clinical practice of photodynamic therapy using talaporfin sodium for esophageal cancer. J Clin Med. 2021;10:2785.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Amanuma Y, Horimatsu T, Ohashi S, et al. Association of local complete response with prognosis after salvage photodynamic therapy for esophageal squamous cell carcinoma. Dig Endosc. 2021;33:355–63.

    Article  PubMed  Google Scholar 

  26. Narahara H. Photodynamic therapy for gastric cancer. Igaku no Ayumi. 2005;215:727–9 (in Japanese).

    CAS  Google Scholar 

Download references

Acknowledgements

We would like to express our gratitude to all the endoscopy medical staff at the Endoscopy department of Fukushima Medical University Hospital for their collaboration and assistance for endoscopic procedures and patient management.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan

    Hidenori Sato, Tsunetaka Kato, Jun Nakamura, Minami Hashimoto, Ryoichiro Kobashi, Takumi Yanagita, Mika Takasumi & Hiromasa Ohira

  2. Department of Endoscopy, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan

    Takuto Hikichi, Tsunetaka Kato, Jun Nakamura, Minami Hashimoto, Ryoichiro Kobashi & Masao Kobayakawa

  3. Medical Research Center, Fukushima Medical University, Fukushima, Japan

    Masao Kobayakawa

Authors
  1. Hidenori Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takuto Hikichi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tsunetaka Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jun Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Minami Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ryoichiro Kobashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takumi Yanagita
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mika Takasumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Masao Kobayakawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hiromasa Ohira
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The conceptualization and designing of this study were carried out by HS, TH, and TK. Endoscopic procedures were performed by HS, TH, TK, and RK. Patient management was done by HS, TK, JN, MH, RK, TY, and MT. The first draft of the manuscript was written by HS, TH, and TK, MK and HO advised on the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Takuto Hikichi.

Ethics declarations

Conflict of interest

Hidenori Sato, Takuto Hikichi, Tsunetaka Kato, Jun Nakamura, Minami Hashimoto, Ryoichiro Kobashi, Takumi Yanagita, Mika Takasumi, Masao Kobayakawa, and Hiromasa Ohira declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from these patient for being included in the paper.

Human rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sato, H., Hikichi, T., Kato, T. et al. Combination of photodynamic therapy and endoscopic mucosal resection for recurrent esophageal squamous cell carcinoma after chemoradiotherapy. Clin J Gastroenterol 15, 1035–1040 (2022). https://doi.org/10.1007/s12328-022-01695-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12328-022-01695-5

Keywords

Search

Navigation