Tanaka Mamoru, Sasaki Makiko, Nishie Hirotada, Kojima Yuki, Sasaki Yasunari, Suzuki Taketo, Fukusada Shigeki, Sugimura Naomi, Ozeki Keiji, Shimura Takaya, Kubota Eiji, Kataoka Hiromi
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Science, Nagoya, Aichi, Japan.
Department of Gastroenterology, Nagoya City University Midori Municipal Hospital, Nagoya, Aichi, Japan.
Int J Clin Oncol. 2025 Sep 2. doi: 10.1007/s10147-025-02864-5.
Esophageal squamous cell carcinoma (ESCC) presents significant treatment challenges, with chemoradiotherapy (CRT) leading to local recurrence in 30-40% of cases. Limitations of traditional salvage therapies have driven interest in photodynamic therapy with talaporfin sodium (TS-PDT), a minimally invasive treatment with reduced phototoxicity, which has been increasingly utilized since its approval in Japan.
This retrospective study at the Nagoya City University Hospital (May 2016-December 2023) assessed the efficacy of TS-PDT for esophageal cancer after CRT or radiotherapy in 29 patients who met specific inclusion criteria. The evaluated outcomes included adverse events, local complete response (L-CR), progression-free survival (PFS), and overall survival (OS).
Among the patients (23 men and 6 women; median age, 72 years), TS-PDT achieved an L-CR rate of 81.5% per patient and 87.8% per lesion, with a higher success rate against T1b lesions. The median local PFS was 44.1 months, and OS had not yet been reached, with a 1-year survival rate of 91.9%. The adverse events included esophageal strictures and perforations.
TS-PDT is a potentially effective salvage treatment for ESCC, offering efficient local control and favorable survival outcomes. Despite some adverse events, its reduced phototoxicity and versatility make it a viable option, particularly for elderly patients. Further multicenter trials are warranted to validate its role in esophageal cancer management.
食管鳞状细胞癌（ESCC）带来了重大的治疗挑战，放化疗（CRT）会导致30%-40%的病例出现局部复发。传统挽救疗法的局限性引发了人们对使用替莫泊芬钠光动力疗法（TS-PDT）的兴趣，这是一种微创治疗方法，光毒性降低，自其在日本获批以来，其应用越来越广泛。
这项在名古屋市立大学医院进行的回顾性研究（2016年5月至2023年12月）评估了TS-PDT对29例符合特定纳入标准的患者在CRT或放疗后食管癌的疗效。评估的结果包括不良事件、局部完全缓解（L-CR）、无进展生存期（PFS）和总生存期（OS）。
在这些患者中（23名男性和6名女性；中位年龄72岁），TS-PDT实现了每位患者81.5%、每个病灶87.8%的L-CR率，对T1b病灶的成功率更高。中位局部PFS为44.1个月，OS尚未达到，1年生存率为91.9%。不良事件包括食管狭窄和穿孔。
TS-PDT是一种对ESCC潜在有效的挽救治疗方法，可实现有效的局部控制并带来良好的生存结果。尽管存在一些不良事件，但其降低的光毒性和多功能性使其成为一个可行的选择，特别是对于老年患者。有必要进行进一步的多中心试验来验证其在食管癌治疗中的作用。
