Photodynamic therapy combined with local chemotherapy for the treatment of advanced esophagocardiac carcinoma

Summary 

Background

Photodynamic therapy (PDT) is an effective palliative treatment for gastrointestinal tumors. The aim of this clinical study was to evaluate the efficacy of PDT combined with local chemotherapy for the treatment of advanced esophagocardiac cancer.

Methods

A total of 140 patients with advanced esophagocardiac cancer were divided into two groups: 42 treated with PDT alone and 98 with combination of PDT and local injection of 5-fluorouracil (5-Fu). The light irradiation was carried out through a diffuser fiber at 24 and 48h after intravenous injection of a domestic photosensitizer PSD-007 (Photocarcinorin, 3–5mg/kg b.w.) at 200–400J/cm under endoscope guidance. Local chemotherapy group was carried out by local injection of 5-Fu (250–500mg) prior to PDT. Treatment was repeated 1–4 times. Short-term and long-term follow up were evaluated.

Results

Short-term efficacy evaluation showed that the rate of significant remission in PDT combined with local chemotherapy group (41.8%) was significantly higher than that in PDT alone group (21.4%, P<0.05). Long-term follow up (up to 36 months) showed that the mean survival time of combined treatment group was longer than that of PDT group (P<0.01).

Conclusion

PDT is safe and effective for advanced esophagocardiac cancer. Its therapeutic effect can be further improved when combined with local chemotherapy.

Keywords: Photodynamic therapy, PSD-007, Local chemotherapy, Advanced esophagocardiac cancer