Medizinische Universität Graz - Research portal
Selected Publication:
Maier, A; Tomaselli, F; Gebhard, F; Rehak, P; Smolle, J; Smolle-Jüttner, FM.
Palliation of advanced esophageal carcinoma by photodynamic therapy and irradiation.
Ann Thorac Surg. 2000; 69(4):1006-1009
Doi: 10.1016/S0003-4975(99)01440-X
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- Leading authors Med Uni Graz
- Maier Alfred
- Co-authors Med Uni Graz
- Rehak Peter
- Smolle Josef
- Smolle-Juettner Freyja-Maria
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- Abstract:
- Background. We wanted to determine the role of photodynamic therapy in a multimodal approach for the treatment of patients with advanced cancer of the esophagus.Methods. We reviewed the cases of 119 patients with nonresectable esophageal carcinoma who underwent endoluminal palliation. Twenty-one patients required initial dilation and tumor obliteration with a neodymium: yttrium-aluminum-garnet laser prior to therapy. Forty-four patients received photodynamic therapy followed by brachyradiotherapy, and 75 patients were treated with brachyradiotherapy. In both groups, some patients also received external-beam irradiation.Results. Photodynamic therapy produced a significant difference in relieving stenosis caused by tumor stenosis (mean, 6.6 mm; p = 0.0000). The dysphagia score improved by one to three levels in all patients, with a significant difference in favor of PDT (p = 0.0003). The mean number of overall treatment sessions was four (range, one to seven). The rate of major complications was 9.2%. Four esophageal perforations occurred, three after intervention and one spontaneously 5 months later. Four esophagorespiratory tract fistulas developed several months after combined PDT and irradiation. The mean overall survival was 7.7 months, and analysis of variance revealed a significant difference in favor of PDT and external-beam irradiation (p = 0.0129 and p = 0.0001, respectively).Conclusions. Photodynamic therapy has been shown to be an effective palliative treatment of advanced esophageal cancer. However, proper patient selection is necessary to prevent serious complications. (C) 2000 by The Society of Thoracic Surgeons.
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