Photodynamic Therapy for Esophageal Tumors

McCaughan, James S.; Nims, Thomas A.; Guy, Jerry T.; Hicks, William; Williams, Thomas E.; Laufman, Leslie R.

doi:10.1001/archsurg.1989.01410010084018

Cited by 106 publications

(21 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The earliest clinical reports of PDT for palliation in esophageal cancer date to the mid-1980s. 94,97,98 Average patient survival in these studies was 7.7 months for those with adenocarcinoma and 5.8 months for those with squamous cell carcinoma.…”

Section: Esophagus Cancer Palliationmentioning

confidence: 83%

Current Concepts in Gastrointestinal Photodynamic Therapy

Webber¹,

Herman²,

Kessel³

et al. 1999

Annals of Surgery

View full text Add to dashboard Cite

ObjectiveTo review current concepts of photodynamic therapy (PDT) applied to the treatment of tumors of the gastrointestinal tract. Summary Background DataPDT initially involves the uptake or production of a photosensitive compound by tumor cells. Subsequent activation of the photoreactive compound by a specific wavelength of light results in cell death, either directly or as a result of vascular compromise and/or apoptosis. MethodsThe authors selectively review current concepts relating to photosensitization, photoactivation, time of PDT application, tissue selectivity, sites of photodynamic action, PDT effects on normal tissue, limitations of PDT, toxicity of photosensitizers, application of principles of PDT to tumor detection, and current applications of PDT to tumors of the gastrointestinal tract. ResultsPDT is clearly effective for small cancers, but it is not yet clear in which cases such treatment is more effective than other currently acceptable approaches. The major side effect of PDT is cutaneous photosensitization. The major limitation of PDT is depth of tumor kill. As data from current and future clinical trials become available, a clearer perspective of where PDT fits in the treatment of cancers will be gained. Many issues regarding pharmacokinetic data of photosensitizers, newer technology involved in light sources, optimal treatment regimens that take advantage of the pharmacophysiology of photoablation, and light dosimetry still require solution. One can foresee application of differing sensitizers and light sources depending on the specific clinical situation. As technologic advances occur, interstitial PDT may have significant application.

show abstract

Section: Esophagus Cancer Palliationmentioning

confidence: 83%

Current Concepts in Gastrointestinal Photodynamic Therapy

Webber¹,

Herman²,

Kessel³

et al. 1999

Annals of Surgery

View full text Add to dashboard Cite

show abstract

“…McCaughan et al [111, 112]treated 56 patients with inoperable oesophageal cancer. In all patients tumour diminution occurred and swallowing improved (an increase in the patent diameter of the oesophagus from 6 to 9 mm).…”

Section: Advanced Cancermentioning

confidence: 99%

Role of Photodynamic Therapy in the Management of Gastrointestinal Cancer

Kubba¹

1999

Digestion

View full text Add to dashboard Cite

Background: Surgery for cancer of the gastrointestinal tract is associated with high morbidity and mortality, especially in older patients. A significant proportion of patients cannot be cured and would be referred for palliative therapy. Others may have early cancer but are deemed unfit for surgery. Chemotherapy and external radiotherapy are suitable for only a proportion of patients. Therefore, photodynamic therapy may have a role in the management of these patients. It was the possibility of achieving selective tumour necrosis with sparing of normal tissue that made this treatment extremely appealing compared to other conventional tumour therapy. Method: The literature is reviewed (after an extensive Medline search 1975–1997) regarding the scientific basis of photodynamic therapy and the clinical experience to date with this therapy in the management of malignancies of the gastrointestinal tract. Results and Conclusions: Photodynamic therapy holds the promise of an eradication form of treatment for early cancer especially for patients deemed unfit for other treatment. It may also prove a useful supplement to other techniques in order to eliminate small residual areas of tumour left after the main bulk has been removed by other methods. The use of photodynamic therapy in the palliative management of gastrointestinal tract cancer is likely to be limited.

show abstract

“…In most cases, In our study, all but one major complication occurred following red light illumination. Esophageal perforation with esophagotracheal or esophagomediastinal fistula formation after PDT for invasive cancers has been previously reported [30,44]. These complications are most often related to the extensive necrosis generated by the treatment.…”

Section: Introductionmentioning

confidence: 99%

“…The reason for the broad range oflight doses applied is that in some cases, the light dose was adapted according to the photosensitizer fluorescence signal measured onto the tumour just before irradiation [25]. In the head and neck field, the esophagus, and the bronchi, PDT has been applied in both superficial and invasive malignancies [26][27][28][29][30][31]. However, the use of PDT to palliate advanced lesions has shown only moderate advantages compared to other methods such as thermal YAG laser vaporization or endoprothesis [32,33].…”

Section: Introductionmentioning

confidence: 99%

“…However, the use of PDT to palliate advanced lesions has shown only moderate advantages compared to other methods such as thermal YAG laser vaporization or endoprothesis [32,33]. Although PDT temporarily reduces the volume of invasive tumors, its benefit is limited by the severe complications, such as haemorrhage and perforation, related to the procedure [30,34]. Thus, the main interest in using PDT is the cure of superficial cancers.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Photodynamic Therapy for 101 Early Cancers of the Upper Aerodigestive Tract, the Esophagus, and the Bronchi: A Single‐Institution Experience

Radu

Grosjean

Fontolliet

et al. 1999

Diagnostic and Therapeutic Endoscopy

View full text Add to dashboard Cite

Cancer, when detected at an early stage, has a very good probability of being eradicated by surgery or radiotherapy. However, less aggressive treatments also tend to provide high rates of cure without the side effects of radical therapy. We report on the results of our clinical experience with photodynamic therapy (PDT) for the treatment of early carcinomas in the upper aerodigestive tract, the esophagus, and the tracheobronchial tree. Sixty-four patients with 101 squamous cell carcinomas were treated with three different photosensitizers:hematoporphyrin derivative (HPD), Photofrin II, and tetra(m-hydroxyphenyl)chlorin (mTHPC). Seventy-seven (76%) tumors showed a complete rsponse with no recurrence after a mean follow-up period of 27 months. There was no significant difference in terms of cure rates among the three dyes. However, mTHPC has a stronger phototoxicity and induces a shorter skin photosensitization than either of the other photosensitizers. There were eight major complications: three esophagotracheal fistulae after illumination with red light in the esophagus, two esophageal stenoses following 360 circumferential irradiation, and three bronchial stenoses. Illumination with the less penetrating green light and the use of a 180 or 240 windowed cylindrical light distributor render the risk of complications in the esophagus essentially impossible, without reducing the efficacy ofthe treatment. Therefore, PDT may be considered as a safe and effective treatment for early carcinomas of the upper aerodigestive tract, the esophagus, and the tracheobronchial tree.

show abstract

Photodynamic Therapy for Esophageal Tumors

Cited by 106 publications

References 29 publications

Current Concepts in Gastrointestinal Photodynamic Therapy

Current Concepts in Gastrointestinal Photodynamic Therapy

Role of Photodynamic Therapy in the Management of Gastrointestinal Cancer

Photodynamic Therapy for 101 Early Cancers of the Upper Aerodigestive Tract, the Esophagus, and the Bronchi: A Single‐Institution Experience

Contact Info

Product

Resources

About