P1.117. Photodynamic Therapy for Esophageal Cancer: A Single-Center Experience With Clinical Outcomes

Abstract

Abstract Topic Esophageal Cancer: Non-Surgical Treatment of Esophageal Cancer Background Photodynamic therapy (PDT) is a minimally invasive local treatment that selectively destroys malignant cells with minimal systemic toxicity. It has emerged as an alternative therapeutic option for superficial esophageal lesions such as carcinoma in situ or high-grade dysplasia, and as a palliative or salvage modality in inoperable cases. This study aimed to evaluate the clinical outcomes and safety of PDT in patients with esophageal cancer treated at a single tertiary center. Methods We retrospectively reviewed 10 patients with esophageal cancer who underwent PDT between 2007 and 2022. Patients with superficial esophageal cancer who were medically inoperable or refused surgery were included. PDT was performed using Photofrin® (porfimer sodium) as the photosensitizer. Clinical response, recurrence, and survival were assessed with a mean follow-up of 25.0 ± 27.7 months. Results Of the 10 patients, 7 (70%) achieved complete remission (CR) and 3 (30%) partial remission (PR). The mean disease-free survival was 24.4 ± 28.0 months (range 3.8–89.8). Two patients experienced locoregional recurrence, which was managed with chemotherapy or repeat PDT. During follow-up, five patients died, of whom four deaths were due to other comorbidities (HCC progression, subglottic cancer, variceal bleeding). Only one death was related to esophageal cancer progression. PDT-related complications were minimal—one esophageal stenosis and one mild skin phototoxicity. Conclusion PDT provides a safe and effective local treatment option for selected patients with esophageal cancer, particularly for superficial lesions in those unfit for or unwilling to undergo surgery. The high remission rate and low complication profile support PDT as a valuable component of individualized, minimally invasive management for esophageal malignancies.