Short-term clinical effect of endoscopic photodynamic therapy on esophageal squamous cell carcinoma and precancerous lesion / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the short?term efficacy and safety of endoscopic photodynamic therapy ( PDT ) for esophageal squamous cell carcinoma ( ESCC ) and precancerous lesion. Methods Retrospective analysis was performed on 30 patients with early ESCC or precancerous lesions who received PDT between September 2013 and April 2015 in Endoscopy Center, Henan Tumor Hospital,and its indications were summarized. The main outcomes including histological complete response rate ( CR ) , recurrence rate and adverse events after treatment of one year were analyzed. Results Three patients with middle grade dysplasia( MGD) , 18 with high grade dysplasia( HGD) and 4 with squamous cell carcinoma in situ, all negative lymph node metastasis, received PDT. CRs were 72?0%(18/25) and 88?0%(22/25)after one PDT session in 3 months and 12 months, respectively. One?year follow?up showed 3 recurrences ( 12?0%) ,4 ( 16?0%) severe strictures, and no perforation. Five patients with advanced squamous cell carcinoma received palliative PDT. Partial remission rate was 60?0%( 3/5) after one PDT session in 3 months, and 40?0% ( 2/5) after 12 months. Two died of tumor metastasis, one died of gastrointestinal bleeding one year after PDT. No perforation occurred. Conclusion Endoscopic photodynamic therapy for esophageal squamous cell carcinoma and precancerous lesions is safe and feasible, with remarkable short?term effect. As for the patients with advanced squamous cell carcinoma, it is equally safe and effective in the short term.