Ishida Natsuki, Osawa Satoshi, Miyazu Takahiro, Kaneko Masanao, Tamura Satoshi, Tani Shinya, Yamade Mihoko, Iwaizumi Moriya, Hamaya Yasushi, Furuta Takahisa, Sugimoto Ken
First Department of Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan.
Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan.
J Clin Med. 2020 May 17;9(5):1509. doi: 10.3390/jcm9051509.
A phase II study of second-generation photodynamic therapy (PDT) using talaporfin sodium has shown excellent treatment results for esophageal cancer with local failure after chemoradiotherapy (CRT) or radiotherapy (RT). However, only a few studies have reported this therapy in clinical practice. This study aimed to confirm the efficacy and safety of salvage PDT using talaporfin sodium for esophageal cancer in various clinical situations. Twelve patients with esophageal cancer with local failure after definitive CRT or RT who underwent PDT using talaporfin sodium were enrolled from April 2016 to January 2020. Overall, 10 patients (83.3%) achieved a local complete response. No skin phototoxicity was observed, but esophageal stricture occurred in five patients (41.7%). Esophageal stricture was improved with endoscopic balloon dilation in all patients, and subsequent analysis found no significant factors causing esophageal stricture after PDT. Two patients with synchronous tumors were successfully rescued by combination therapy with endoscopic submucosal dissection. Two patients with carcinoma in situ of larger than 1/2 circumference were rescued by repeated PDT. The 2-year overall survival was 80.0% (95% confidence interval 0.409-0.946). PDT using talaporfin sodium was an effective and safe salvage treatment for esophageal cancer with local failure after CRT or RT in various clinical situations.
一项使用替莫泊芬钠的第二代光动力疗法（PDT）的II期研究显示，对于放化疗（CRT）或放疗（RT）后局部复发的食管癌，该疗法取得了优异的治疗效果。然而，仅有少数研究报道了这种疗法在临床实践中的应用。本研究旨在证实使用替莫泊芬钠的挽救性PDT在各种临床情况下治疗食管癌的疗效和安全性。2016年4月至2020年1月，纳入了12例接受CRT或RT后局部复发的食管癌患者，这些患者接受了使用替莫泊芬钠的PDT治疗。总体而言，10例患者（83.3%）实现了局部完全缓解。未观察到皮肤光毒性，但5例患者（41.7%）出现了食管狭窄。所有患者通过内镜球囊扩张后食管狭窄均得到改善，随后的分析发现PDT后没有导致食管狭窄的显著因素。2例同时性肿瘤患者通过内镜黏膜下剥离术联合治疗成功获救。2例原位癌周长大于1/2的患者通过重复PDT获救。2年总生存率为80.0%（95%置信区间0.409 - 0.946）。在各种临床情况下，使用替莫泊芬钠的PDT是治疗CRT或RT后局部复发食管癌的一种有效且安全的挽救性治疗方法。
