Effect of photodynamic therapy in a multimodal approach for advanced carcinoma of the gastro-esophageal junction

Maier, Andrea B.; Anegg, Udo; Fell, B.; Tomaselli, Florian; Sankin, Oliver; Prettenhofer, Ulrike; Pintér, H; Rehak, Peter; Friehs, G; Smolle‐Jüttner, Freyja Maria

doi:10.1002/1096-9101(2000)26:5<461::aid-lsm5>3.0.co;2-t

Cited by 28 publications

(25 citation statements)

References 19 publications

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“…Several reports and clinical pilot studies of successful esophageal PDT -even conducted at our department -are documented in literature [25,[37][38][39][40][41][42].…”

Section: Methodsmentioning

confidence: 99%

The clinical impact of photodynamic therapy in thoracic surgery

et al. 2010

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Zusammenfassung. Grundlagen: Die Prognose von Patienten mit malignem Pleuramesotheliom, inoperablem fortgeschrittenen Ö sophagus-oder Bronchuskarzinom ist nach wie vor sehr trist. Die photodyname Therapie (PDT) stellt eine sehr wirkungsvolle Option in der Palliativtherapie dieser Malignome dar.Methodik: Die Funktionsweise der PDT beruht auf der Illuminierung von Malignomen nach vorangegangener intravenöser Photosensibilisierung und konsekutiver selektiver Tumorzellnekrose. Im Falle des Ö sophaguskarzinoms als auch der malignen Bronchusstenose wird die PDT endoskopisch durchgefü hrt, beim malignen Pleuramesotheliom geschieht dies intraoperativ im Anschluss an die Dekortikation.Ergebnisse: Mit Hilfe der PDT wird eine signifikante Reduktion der endoluminalen bzw. intrakavitären Tumormasse, verbunden mit deutlich verbesserter Lebensqualität und verlängertem rezidiv-freiem Intervall, erreicht. Außerdem kann der Patient dadurch fü r weitere palliative Therapiemaßnahmen konditioniert werden.Schlussfolgerungen: Die PDT stellt eine sichere, gut durchfü hrbare und äußerst wirksame Option in der endoskopischen Palliativtherapie des fortgeschrittenen Ö sophagus-als auch des Bronchuskarzinoms dar. Ü berdies kann die PDT als supportive Maßnahme in der chirurgischen Therapie des malignen Pleuramesothelioms eingesetzt werden.Schlüsselwörter: Ö sophaguskarzinom, Bronchuskarzinom, malignes Pleuramesotheliom, photodyname Therapie, palliative Therapie.Summary. Background: Patients suffering from malignant pleural mesothelioma, advanced esophageal cancer or progressive lung cancer, ineligible for resection, still have a poor prognosis. Photodynamic Therapy (PDT) is a very effective approach in the palliative treatment regimen of these malignancies.Methods: The mechanism of function is based on the illumination of malignant tissue after selective accumulation of photosensitizers in tumor cells resulting in local tumor necrosis. In case of esophageal cancer and malignant bronchogenic stenosis, PDT is performed endoscopically whereas in malignant pleural mesothelioma intra-cavitary PDT is done after decortication.Results: Significant reduction of the endoluminal/ intrathoracic tumor associated with increased quality of life and prolonged disease-free survival can be achieved which helps conditioning the patient for further palliative treatment procedures.Conclusions: PDT has become a safe, feasible, and efficient approach in the endoscopic palliation of advanced esophageal cancer, malignant tracheo-bronchial stenosis as well as a supportive treatment option in the surgical management of malignant pleural mesothelioma.

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“…Several reports and clinical pilot studies of successful esophageal PDT -even conducted at our department -are documented in literature [25,[37][38][39][40][41][42].…”

Section: Methodsmentioning

confidence: 99%

The clinical impact of photodynamic therapy in thoracic surgery

et al. 2010

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“…By using this method of analysis and working backward from tissue doses, the light dose of 300 J/cm at the fibre tip was determined to give a safe, yet effective, range of tumour necrosis [40,41]. This light dose was still lower than that which had been previously used.…”

Section: Light Deliverymentioning

confidence: 99%

“…In literature oxygen administration during PDT was described as (1) simple nasal oxygen support of only 3-4 L/min [66], (2) general anaesthesia with intubation and FiO 2 of 0.21-1.0 [35,36,40,41,67] and additional hypberbaric oxygenation with enhanced effectivity [68].…”

Section: Oxygen Supply For Esophageal Pdtmentioning

confidence: 99%

“…At this time the general recommendation for clinical practice in PDT application is general anaesthesia with orotracheal intubation and oxygen supply using 1.0 FiO 2 during PDT [67,40,41].…”

Section: Oxygen Supply For Esophageal Pdtmentioning

confidence: 99%

“…Topical sunscreens are generally ineffective in preventing phototoxicity because they block only ultraviolet light. However, skin protection by the use of sunblocker was done in clinical practice with a very low rate of sunburn [35,36,40,41]. Because of the disfiguring effect, patients usually decline its use after discharge from the hospital.…”

Section: Practical Considerations For Clinical Pdt Of Esophageal Carcmentioning

confidence: 99%

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Photodynamic therapy for esophageal carcinoma*

et al. 2011

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Background: Patients suffering from advanced esophageal cancer ineligible for resection still have a poor prognosis. Photodynamic Therapy (PDT) is a very effective approach in the endoluminal palliative treatment regimen of this malignancy.Methods: The mechanism of function is based on the illumination of malignant tissue after selective accumulation of photosensitizers in tumour cells resulting in local tumour necrosis. In case of esophageal cancer, PDT is performed endoscopically under general anaesthesia.Results: Significant reduction of the endoluminal tumour associated with increased quality of life can be achieved which helps conditioning the patient for further palliative treatment procedures.Conclusions: Local endoluminal palliation with the aim to improve swallowing, decrement of dysphagia and therefore improvement of the patient's quality of life are the main therapeutic goals of PDT in case of inoperable esophageal cancer. Therefore, PDT has become a more and more accepted as well as safe, feasible and efficient endoscopic treatment option within the multimodal palliation regimen of advanced esophageal cancer.

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