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Photodynamic Therapy Effective In Palliating Oesophageal Cancer Patients: Presented at STS

By Ed Susman
Special to DG News

SAN DIEGO, CA -- February 4, 2003 -- Photodynamic therapy can improve symptoms for patients with malignant dysphasia and bleeding associated with oesophageal cancer.

"Photodynamic therapy was effective in palliating patients with obstructing oesophageal cancer in 85% of cases and stopped bleeding in 90% of cases," said Virginia Litle, MD, a thoracic surgeon at the University of Pittsburgh in Pennsylvania, United States.

In an oral presentation at the 39^th Annual Meeting of the Society of Thoracic Surgeons, Dr. Litle reported her experience in administering 318 courses of the therapy to 215 patients for palliative treatment. She said that one course of photodynamic therapy stopped the bleeding in 29 of 31 patients who were treated for bleeding complications of their disease.

"Photodynamic therapy utilizes a photosensitizing agent -- Photofrin, light and oxygen to endoscopically ablate cancer cells," she explained. Data were reviewed on 215 patients treated between November 1996 and June 2002, 50 were women. The patients ranged in age from 22 to 93 years and had an average survival of 4.8 months following the palliation treatment. Eleven patients in the cohort remain alive five years after treatment.

Four treatment-related deaths were reported -- about 1.5% of those who received the therapy. First degree sunburn occurred in 6% of patients but no-one experienced anything worse than the first degree burns.

Stephen R. Hazelrigg, MD, of Southern Illinois University questioned the extent of sunburn in the patients. The concern was the length of time patients would have to avoid sun exposure for a month after treatment -- which could be a problem for patients who may only have a survival of less than five months, he suggested. Dr. Litle, however, felt that the patients did not consider this to be a problem.

Use of photodynamic therapy can also improve symptoms for patients in whom oesophageal stents have been implanted in a attempt to keep the oesophagus open, and in whom there has been tissue overgrowth through the stent, Dr. Litle added.

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