Although surgery still holds “the highest place” in treatment of operable esophageal cancer, photodynamic therapy (PDT) represents an effective, minimally invasive treatment option in selected patients, declared Keyvan Moghissi, BSc, MD, MS, FRCS, FETCS, Director and Consultant, Cardiothoracic Surgeon, at Yorkshire Laser Centre in East Yorkshire, England. With many years of experience with PDT for esophageal lesions, Dr. Moghissi believes that the emerging indications for PDT include in early esophageal cancer for those who are ineligible for surgical resection, for locally advanced malignant tumors with exophytic obstructive lesions and no distant metastases, and as salvage when other treatment options have failed.
The standard treatment of esophageal cancer centers on the triad of surgery, chemotherapy, and radiotherapy. Other therapeutic alternatives have included endoscopic mucosal resection, chemoradiotherapy, radiofrequency ablation, cryotherapy, thermal laser therapy, and PDT. However, Dr. Moghissi admits, “no one has done what would be satisfactory: randomized trials to compare these options.” This article reviews outcomes obtained with PDT for esophageal cancer and explores the treatment settings in which it may be most effective.
Sawant D, Moghissi K. Management of unresectable oesophageal cancer: a review of 537 patients. Eur J Cardiothorac Surg 1994;8:113–117.
Sharpe DA, Moghissi K. Resectional surgery in carcinoma of the oesophagus and cardia: what influences long-term survival? Eur J Cardiothorac Surg 1996;10:359–364.
Moghissi K, Dixon K. Photodynamic therapy (PDT) in esophageal cancer: a surgical view of its indications based on 14 years’ experience. Technol Cancer Res Treat 2003;2:319–326.
Moghissi K, Hornshaw J, Teasdale PR. Enteral nutrition in carcinoma of the oesophagus treated by surgery: nitrogen balance and clinical studies. Br J Surg 1977;64:125–128.
Balázs A, Kokas P, Lukovich P, Kupcsulik P. Palliative management of malignant oesophageal strictures with endoprosthesis implantation: 25 years’ experience. Magy Seb 2011;64:267–276.
Moghissi K, Dixon K, Stringer M, Thorpe JA. Photofrin PDT for early stage oesophageal cancer: long term results in 40 patients and literature review. Photodiagnosis Photodyn Ther 2009;6:159–166.
Li LB, Xie JM, Zhang XN et al. . Retrospective study of photodynamic therapy vs photodynamic therapy combined with chemotherapy and chemotherapy alone on advanced esophageal cancer. Photodiagnosis Photodyn Ther 2010;7:139–143.