Document Detail


Nonoperable patients with superficial esophageal cancer treated by photodynamic therapy after chemoradiotherapy have more severe complications than patients treated in primary intent.
MedLine Citation:
PMID:  18844614     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Photodynamic therapy (PDT) is a therapeutic option in patients with a superficial esophageal cancer. Recently, PDT was shown to be effective as a salvage therapy for a local recurrence after chemoradiotherapy (CRT). AIM: To compare retrospectively the results and the complications rate of PDT between consecutive patients treated in primary intent for a superficial esophageal cancer versus patients treated by PDT for a local recurrence after CRT. METHODS: Between 1999 and 2007 in a single center, 40 consecutive patients were treated by PDT for a superficial esophageal cancer, 25 (group 1) in primary intent and 15 (group 2) for a local recurrence after CRT. Two days after intravenous (IV) Photofrin (2 mg/kg), the phototherapy was performed with a dye laser. The treatment response and severe complications, defined as perforation and stricture requiring endoscopic dilation, were compared between the two groups. RESULTS: The patient and tumor characteristics were not different between the two groups. In group 1, 19 out of 25 patients (76%) were successfully treated versus 8 out of 15 patients (53%) in group 2 (P= 0.17). Severe complications occurred more frequently in patients with a prior CRT (8%vs 46.7%, P= 0.008) and included two perforations and five strictures requiring endoscopic dilation, while only two strictures occurred in group 1. A prior CRT was an independent risk factor of severe complications (odds ratio [OR] 8.05; 95% confidence interval [CI]1.22-43.0). CONCLUSIONS: Severe complications were significantly more frequent in patients treated after a prior CRT. PDT as a salvage therapy in patients with a local recurrence after CRT for esophageal cancer tended to be less efficient than in first-line treatment.
Authors:
Stéphane Lecleire; Frédéric Di Fiore; Michel Antonietti; Emmanuel Ben-Soussan; Patrick Hochain; Eric Lerebours; Pierre Michel; Philippe Ducrotté
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  103     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-10-10     Completed Date:  2008-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2215-9     Citation Subset:  IM    
Affiliation:
Department of Hepato-Gastroenterology and Nutrition and Appareil Digestif et Nutrition Equipe d'Accueil 3234, Rouen University Hospital, Rouen, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Chi-Square Distribution
Combined Modality Therapy
Dihematoporphyrin Ether / adverse effects,  therapeutic use
Esophageal Neoplasms / drug therapy,  pathology,  radiotherapy,  therapy*
Esophagoscopy
Female
Humans
Logistic Models
Male
Neoplasm Staging
Photochemotherapy / adverse effects*
Photosensitizing Agents / adverse effects,  therapeutic use
Retrospective Studies
Risk Factors
Salvage Therapy
Statistics, Nonparametric
Treatment Outcome
Chemical
Reg. No./Substance:
0/Photosensitizing Agents; 97067-70-4/Dihematoporphyrin Ether

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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