Combined Local Therapy of Photodynamic Therapy and External Beam Radiotherapy in Advanced Esophageal Cancer with Chronic illness: Preliminary Report

Purpose: The best treatment in advanced esophageal cancer is combined chemoradiotherapy with or without surgery. In spite of the advance results of multimodality therapy, esophageal cancer patients were still treated with external beam radiotherapy (ERT) alone. We report the outcome of combined photodynamic therapy (PDT) and ERT in a local therapeutic approach for patients with advanced esophageal cancer with chronic illness. Materials and Methods: Six patients with esophageal cancer were treated curatively with PDT-ERT. ERT was delivered with a total of median 55.8 Gy per 45 days. All patients were treated with one-time PDT median 14 days before ERT. The median follow up period after PDT-ERT was 25 months ranged from 1 to 72 months. Results: The median survival was 27 months. The overall survival rate in 1 year and 2 years were 67% (4/6) and 33% (2/6), respectively. By endoscopy, the complete response rate 1~3 months after PDT-ERT was 50% (3/6). Conclusion: This paper showed that the combination of ERT-PDT as a local therapy provided more durable survival and palliation than RT alone. It is expected that PDT addition to ERT will improve tumor control and increase survival rate in advanced esophageal cancer with chronic illness.