Summary
Photodynamic therapy (PDT) utilizing either hematoporphyrin derivative or Photofrin II is proving to be an effective modality in the treatment of early superficial (ES) or advanced invasive (AI) carcinoma of the esophagus. An argon-pumped dye laser was used to deliver 630 nm light via quartz fibers passed through the biopsy channel of a gastroscope after intravenous injection of photosensitizer. Between 1982 and 1989, 20 patients (ES=6; AI=14) were treated in this manner. Complete remission was obtained in 4 of 6 ES cases, and the mean survival after PDT alone or in combination with other therapy was 27 months. Five patients remain alive to date. In the AI group, significant remissions were obtained in 6 cases while partial remissions were observed in another 8. The mean dysphagia grade improved from 4.0 to 2.8. We conclude that PDT is efficacious in the treatment of ES esophageal cancer, where complete remission may be achieved, and as palliative therapy in advanced cases to alleviate dysphagia.
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Berns MW, Dahlman A, Johnson FM, Burns R, Sperling D, Guiltinan M, Siemens A, Walter R, Wright W, Wilson MH, Wile A (1982) In vitro cellular effects of hematoporphyrin derivative. Cancer Res 42: 2325–2329
Forbes IJ, Cowled PA, Leong AS, Ward AD, Black RB, Blake AJ, Jacka FJ (1980) Phototherapy of human tumors using hematoporphyrin derivative. Med J Aust 2: 489–493
Dougherty TJ (1986) Photosensitization of malignant tumors. Semin Surg Oncol 2: 24–37
Dougherty TJ, Lawrence G, Kaufman JH, Boyle DG, Weishaupt KR, Goldfarb A (1979) Photoradiation in the treatment of recurrent breast carcinoma. J Natl Cancer Inst 62: 231–237
Hayata Y, Kato H, Conaka C, Ono J, Takizawa N (1982) Hematoporphyrin derivative and laser photoradiation in the treatment of lung cancer. Chest 81: 269–277
Kato H, Konaka C, Ono J, Kawate N, Nishimiya K, Shinihara H, Saito M, Sakai H, Kito T, Aizawa K, Hayata Y (1985) Preoperative laser photodynamic therapy in combination with operation in lung cancer. J Thorac Cardiovasc Surg 90: 420–429
Kato H, Aizawa K, Shinohara H, Konaka C, Hayata Y (1986) Cytomorphological changes caused by hematoporphyrin derivative and photodynamic therapy. Laser Life Sci 1: 13–27
Kato H, Konaka C, Kawate N, Shinohara H, Kinoshita K, Noguchi M, Ootomo S, Hayata Y (1986) Five-year disease-free survival of a lung cancer patient treated only by photodynamic therapy. Chest 90: 768–770
Krasner N, Barr H, Skidmore C, Morris AI (1987) Palliative laser therapy for malignant dysphagia. Gut 28: 792–798
Lipson RL, Baldes EJ, Olsen AM (1961) The use of hematoporphyrin in tumor detection. J Natl Cancer Inst 26: 1–8
McCaughan JS, Williams TE, Bethel BH (1985) Palliation of esophageal malignancy with photodynamic therapy. Ann Thorac Surg 40: 113–120
McCaughan JS, Nims TA, Guy JT, Hicks WJ, Williams TE, Laufman LR (1989) Photodynamic therapy for esosphageal tumors. Arch Surg 124: 74–80
Postlethwait RW (1983) Complications and deaths after operations for esophageal carcinoma. J Thorac Cardiovasc Surg 85: 827–831
Raab O (1900) Über die Wirkung fluorescierender Stoffe auf Infusorien. Z Biol 39: 524–546
Weishaupt KR, Gomer CJ, Dougherty TJ (1976) Identification of singlet oxygen as the cytotoxic agent in photoinactivation of a murine tumor. Cancer Res 36: 2326–2329
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Okunaka, T., Kato, H., Conaka, C. et al. Photodynamic therapy of esophageal carcinoma. Surg Endosc 4, 150–153 (1990). https://doi.org/10.1007/BF02336594
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DOI: https://doi.org/10.1007/BF02336594