Photodynamic therapy with porfimer sodium versus thermal ablation therapy with Nd:YAG laser for palliation of esophageal cancer: a multicenter randomized trial

Lightdale, Charles J.; Heier, S.K.; Marcon, Norman E.; McCaughan, James S.; Gerdes, Hans; Overholt, Bergein F.; Sivak, Michael; Stiegmann, Gregory V.; Nava, Hector

doi:10.1016/s0016-5107(95)70002-1

Cited by 299 publications

(121 citation statements)

References 15 publications

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“…In a prospective, randomized multicenter trial PDT (Photofrin) was compared with neodymium:yttrium-aluminum-garnet (Nd : YAG) laser therapy in 236 patients with advanced esophageal cancer. Improvement of dysphagia was equivalent with the either of the treatments (55). Objective tumor response at 1 month was superior with PDT, although it produced more toxicity, but fewer perforations (1% vs. 7%).…”

Section: Metastatic Diseasementioning

confidence: 83%

“…Radiotherapy alone versus surgery alone can only be compared indirectly since there are no randomized clinical trials. Controlled clinical trials do not show any survival bene t for patients treated postoperatively with 30 Gy (27) or [49][50][51][52][53][54][55][56]29). Radiotherapy can thus not be recommended as a single modality treatment or as the only adjuvant therapy with surgery in a curative approach.…”

Section: Radiotherapymentioning

confidence: 99%

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Chemoradiotheraphy of Esophageal Cancer

Albertsson

2002

Acta Oncologica

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Section: Metastatic Diseasementioning

confidence: 83%

Section: Radiotherapymentioning

confidence: 99%

Chemoradiotheraphy of Esophageal Cancer

Albertsson

2002

Acta Oncologica

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“…Th ese complications included a fi stula to the respiratory tract in fi ve patients, and esophageal perforation in one patient, which was most likely due to the preliminary dilation with a Savary-Gilliard bougie. Th e rate of serious complications observed in our study was lower than that following Nd -YAG laser re-canalization ( 17,25 ). With midazolam sedation, the APC sessions were well tolerated.…”

Section: Discussionmentioning

confidence: 51%

Randomized Comparison of Three Palliative Regimens Including Brachytherapy, Photodynamic Therapy, and APC in Patients With Malignant Dysphagia (CONSORT 1a) (Revised II)

Rupiński

Zagórowicz

Reguła

et al. 2011

American Journal of Gastroenterology

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Because most esophageal cancers are diagnosed at an advanced stage, a majority of patients require palliative dysphagia treatment. Dysphagia severity and the need for repeated re-canalization procedures signifi cantly affect patients ' quality of life (QoL). The aim of this study was to establish whether combining argon plasma coagulation (APC) of the neoplastic esophageal tissue with another re-canalization method results in a longer dysphagia-free period compared with APC alone. METHODS:We conducted a randomized trial in 93 patients with malignant dysphagia. Patients were followed until death. We compared three regimens of esophageal re-canalization; APC combined with high dose rate (HDR) brachytherapy, APC combined with photodynamic therapy (PDT), and APC alone. The primary outcome measure was the dysphagia-free period following randomization. Secondary measures were survival, QoL, treatment-associated complications, and treatment tolerance. A per-protocol analysis was carried out. RESULTS:The time to fi rst dysphagia recurrence was signifi cantly different between each combination treatment group and the control group (overall test: P = 0.006; HDR vs. control, log-rank P = 0.002, PDT vs. control, log-rank P = 0.036), but not different between the combination groups (HDR vs. PDT, log-rank P = 0.36). The median time to fi rst dysphagia recurrence was 88, 59, and 35 days in the HDR, PDT, and control groups, respectively. There was no difference in overall survival between the study groups ( P = 0.27). No deaths, perforations, hemorrhages, or fi stula formations were attributed to treatment. The only major complication was fever, occurring in three PDT patients. Minor complications were observed signifi cantly more often in the combination treatment groups and included pain in both groups, transient dysphagia worsening, and skin sensitivity in the PDT group. The QoL 30 days after treatment in the HDR group was signifi cantly better than in the other groups.CONCLUSIONS: In patients with inoperable esophageal cancer, palliative combination treatment of dysphagia with APC and HDR or PDT was signifi cantly more effi cient than APC alone, and was safe and well tolerated. APC combined with HDR resulted in fewer complications and better QoL than APC with PDT or APC alone (CONSORT 1b).SUPPLEMENTARY MATERIAL is linked to the online version of the paper at

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“…Hematoporphyrin derivatives (HpDs) such as Photofrin® (Porfimer sodium) have been approved for use against gastrointestinal cancer and early lung cancer. [10][11][12] From the early 1990s, in addition to the use of PDT for tumors, PDT with HpDs (HpDs-PDT) activated with red or green laser (510-630 nm) has been studied for the treatment of cutaneous vascular lesions. 1 3-1 5 PDT for PWS is based on a photochemical reaction, and not a thermal reaction.…”

Section: Introductionmentioning

confidence: 99%

Histological Responses of Cutaneous Vascular Lesions Following Photodynamic Therapy with Talaporfin Sodium: A Chicken Comb Model

et al. 2009

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Background: Mono-L-aspartyl chlorin e6 (Talaporfin sodium) is a novel photosensitizer, and is currently being used in photodynamic therapy for various malignant tumors in combination with irradiation with a 664 nm laser. An interesting characteristic of Talaporfin sodium is that the skin photosensitivity after injection of this agent disappears faster than any other existing photosensitizers. This study examined the vascular events that occurred postirradiation in the chicken comb as a capillary malformation model after photosensitization with Talaporfin sodium. Materials and Methods: A single intravenous bolus injections of Talaporfin sodium was administered to the chickens, and a 1 cm diameter area of the comb of each animal was irradiated with a 664 nm visible red laser. The gross changes in the chicken combs were recorded for 7-14 days after photodynamic therapy. For the histological examination, HE, PTAH and Azan stained sections were analyzed. Results: All treated chicken combs had blanched after photodynamic therapy. Microscopy demonstrated an absence of erythrocytes and the vessel lumina were obliterated, leaving the normal overlying epidermis completely intact. Concomitantly with selective destruction of the capillaries in the target area, moderate invasion of inflammatory cells and a slight increase in the stroma were observed. Conclusions: In the chicken comb model, photodynamic therapy with Talaporfin sodium effectively achieved selective destruction of the microvasculature while leaving the epidermis intact. Our results strongly suggest that photodynamic therapy with Talaporfin sodium could be a feasible method to treat dermal hypervascular lesions. (Keio J Med 58 (3) : 176 -184, September 2009)

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Photodynamic therapy with porfimer sodium versus thermal ablation therapy with Nd:YAG laser for palliation of esophageal cancer: a multicenter randomized trial

Cited by 299 publications

References 15 publications

Chemoradiotheraphy of Esophageal Cancer

Chemoradiotheraphy of Esophageal Cancer

Randomized Comparison of Three Palliative Regimens Including Brachytherapy, Photodynamic Therapy, and APC in Patients With Malignant Dysphagia (CONSORT 1a) (Revised II)

Histological Responses of Cutaneous Vascular Lesions Following Photodynamic Therapy with Talaporfin Sodium: A Chicken Comb Model

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