Introduction:
Esophageal cancer is one of the most common cancers worldwide. Chemoradiotherapy (CRT) is one of the curative treatments for esophageal cancer in patients with unresectable tumors or those who refuse surgery.
Talaporfin sodium, a second-generation photosensitizer, is rapidly cleared from the skin and requires a shorter sun-shade period (2 weeks).
In this study, we evaluated the efficacy of PDT with talaporfin sodium for local failure after CRT for esophageal cancer.
Methods:
Patients with histologically proven local failure limited within the muscularis propria after radiotherapy (RT) of 50 Gy or more for esophageal cancer were eligible.
The PDT procedure commenced with intravenous administration of a 40 mg/m2-dose of talaporfin sodium, followed by laser irradiation at a 664 nm wavelength 4 to 6 hours after administration. The fluence of the diode laser was set at 100 J/cm2 with a fluence rate of 150 mW/cm2.
The local efficacy was classified based on endoscopic evaluation as local complete response (L-CR).
Result:
Sixteen patients with a total of 19 lesions received additional laser irradiation. The median total laser exposure dose was 298 (range: 100–800) J. Thirteen patients with a total of 16 lesions achieved L-CR after PDT (L-CR rate: 84.2%); all of L-CR achieved within 12 weeks after PDT. The L-CR rate of T1 failure lesions was 92.8% (13/14), whereas the L-CR rate of T2 failure lesions was 60.0% (3/5).
Two patients (9.1%) who underwent PDT developed an esophageal perforation and were managed with non-surgical measures. There was no case of treatment-related death.
Conclusion:
PDT using talaporfin sodium and a diode laser is a safe and curative salvage treatment for local failure after CRT for patients with esophageal cancer. The possibility of esophageal perforation after PDT should be considered for longer than 1 month post-therapy.
Methods: G-chlorin e6 was synthesized with a core photosensitizer chlorin e6 conjugated to glucose. 1); The half maximal inhibitory concentration (IC50) was measured to compare the PDT effects of G-chlorin e6 and TS. 2); Flow cytometry was performed to examine the accumulation of G-chlorin e6 in cancer cells. We also compared the accumulation of G-chlorin e6 between normal immortalized esophageal epithelial cells and esophageal cancer cells. 3); In vivo using mice evaluation, the radio activated carbon 14 labeled G-chlorin e6 was manufactured for evaluation of the excretion from the body. 4); Antitumor effects of G-chlorin e6 PDT were analyzed in allograft tumor mouse models.
Results: 1); PDT in vitro using G-chlorin e6 elicited 9, 000-34,000 times stronger antitumor effects than TS. 2); there was 70-190 times more G-chlorin e6 accumulated than TS by flow cytometry. G-chlorin e6 accumulated more selectively in esophageal cancer cells than in esophageal immortalized epithelial cells. 3); The excretion of G-chlorin e6 from plasma to bile juice was much faster than that of TS. 4); In an allograft model, PDT with G-chlorin e6 showed very strong antitumor effects and a 40% complete response (CR) rate.
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