Photodynamic therapy for esophageal carcinoma*

Abstract

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.

Photodynamic therapy downregulates the function of regulatory T cells in patients with esophageal squamous cell carcinoma

“…1 Geographically, its incidence varies from approximately 10 cases per 100 000 persons in Europe and the United States to 139 cases per 100 000 persons in some areas of China. [2][3][4] The most common tumor subtype is esophageal squamous cell carcinoma (ESCC), which is associated mainly with tobacco smoking 5,6 and heavy alcohol use 6 but also with age >60 years, male gender, and heredity. 1,7,8 The standard of care for esophageal cancer combines surgery, chemotherapy, and radiotherapy.…”

“…[12][13][14][15] After decades of clinical use, PDT is now considered a feasible and efficient minimally invasive endoscopic option for treatment of early unresectable ESCC, palliation of locally advanced disease, and salvage when other treatment options have failed. 2,16,17 We and others have successfully employed PDT alone or as part of a multimodal approach to the palliative treatment of advanced esophageal cancers. [18][19][20] In our experience, PDT produces a statistically significant advantage in relieving stenosis, improving dysphagia, and improving mean survival.…”

Programmed death ligand 2 expression plays a limited role in adenocarcinomas of the gastroesophageal junction after preoperative chemotherapy

“…Gastroesophageal adenocarcinoma (AEG) is one of the ten most common causes of cancer deaths worldwide [1,2]. Even though the use of multimodal therapies combining surgery, cytotoxic chemotherapy, radiotherapy, and targeted therapy has improved patients' survival rates, 5-year survival rates remain poor, at 10-15% [3][4][5][6][7]. The majority of patients present with locally advanced AEG and are therefore eligi-original article ble for preoperative treatment [8,9].…”