Nishikawa Michiko, Yamamoto Yoshinobu, Kushida Saeko, Hirabayashi Taku, Tanaka Syunta, Takegawa Naoki, Mimura Takuya, Tsumura Hidetaka, Miki Ikuya, Tsuda Masahiro
Department of Gastroenterological Oncology Hyogo Cancer Center Hyogo Japan.
Department of Gastroenterology Kakogawa Central City Hospital Hyogo Japan.
DEN Open. 2022 Sep 25;3(1):e167. doi: 10.1002/deo2.167. eCollection 2023 Apr.
Chemoradiotherapy (CRT) or radiotherapy (RT) alone is often the treatment of choice for elderly patients with esophageal cancer with the expectation of organ preservation. However, salvage treatment remains a problem when endoscopic resection is not indicated for local failure after CRT/RT. Photodynamic therapy (PDT) is indicated for local failure after CRT/RT, but there are few reports on its efficacy and safety in elderly patients. This study aimed to assess the outcome of PDT for local failure after CRT/RT for esophageal cancer in elderly patients.
This retrospective single-center study included 42 patients who first underwent PDT between April 2013 and June 2021. Patients aged ≥80 and <80 years were classified into the elderly and nonelderly groups, respectively. Local complete response rate, overall survival, progression-free survival, and incidence of adverse events related to PDT were compared retrospectively between the groups.
The local complete response rate was 93.3% in the elderly group and 85.7 in the non-elderly group. The 2-year overall survival rate was 68.6% and 72.5%, and the 2-year progression-free survival rate was 49.5% and 70.0% in the elderly and nonelderly groups, respectively. There was no significant difference in any of these outcomes between the groups. In terms of adverse events, pneumonia and delirium tended to occur more frequently in the elderly group, but there were no serious adverse events in either group.
The outcome of salvage PDT in the local control was comparable between the elderly and nonelderly patients for local failure after CRT/RT for esophageal cancer.
对于老年食管癌患者，单纯放化疗（CRT）或放疗（RT）通常是期望保留器官的首选治疗方法。然而，当CRT/RT后局部失败而不适合内镜切除时，挽救性治疗仍然是一个问题。光动力疗法（PDT）适用于CRT/RT后的局部失败，但关于其在老年患者中的疗效和安全性的报道很少。本研究旨在评估老年食管癌患者CRT/RT后局部失败采用PDT的治疗结果。
这项回顾性单中心研究纳入了2013年4月至2021年6月期间首次接受PDT的42例患者。年龄≥80岁和<80岁的患者分别分为老年组和非老年组。回顾性比较两组之间的局部完全缓解率、总生存期、无进展生存期以及与PDT相关的不良事件发生率。
老年组的局部完全缓解率为93.3%，非老年组为85.7%。老年组和非老年组的2年总生存率分别为68.6%和72.5%，2年无进展生存率分别为49.5%和70.0%。两组在这些结果方面均无显著差异。在不良事件方面，老年组肺炎和谵妄的发生率往往更高，但两组均未出现严重不良事件。
老年和非老年食管癌患者在CRT/RT后局部失败采用挽救性PDT的局部控制结果相当。
