Photodynamic therapy for esophageal tumors
J. S. McCaughan Jr, T. A. Nims, J. T. Guy, W. J. Hicks, T. E. Williams Jr and L. R. Laufman
Department of Surgery, Grant Medical Center, Columbus, Ohio.
Between 1982 and 1987, 40 patients with esophageal tumors (19
adenocarcinomas, 19 squamous carcinomas, and two melanomas) in whom
conventional treatments were unsuccessful were treated with photodynamic
therapy (PDT) after injection with either hematoporphyrin derivative or
dihematoporphyrin ether. Patients underwent endoscopy again two to three
days and one month after PDT and as needed when symptoms recurred. At one
month, the average minimal diameter opening of 28 assessable tumors
increased from 6 to 9 mm. Of the 35 patients who could be evaluated one
month after PDT, the average improvement in food intake was from a liquid
to a soft diet. Average survival time (from time of first treatment) was
7.7 months (n = 17) for adenocarcinoma, 5.8 months (n = 12) for squamous
cell carcinoma, and 25 months (n = 2) for melanoma. Two patients with stage
I adenocarcinoma were alive with no evidence of disease at 11 and 23
months. One patient with stage I squamous cell cancer died 18 months after
PDT, with recurrence of tumor above the treated area noted eight months
after treatment. One patient with stage I melanoma died of a synchronous
colon cancer 31 months after PDT, with no evidence of residual melanoma.
