Efficacy and safety of talaporfin sodium photodynamic therapy as a salvage treatment for locally recurrent esophageal squamous cell carcinoma.

Background: Esophageal squamous cell carcinoma (ESCC) presents significant treatment challenges, with chemoradiotherapy (CRT) leading to local recurrence in 30-40% of cases. Limitations of traditional salvage therapies have driven interest in photodynamic therapy with talaporfin sodium (TS-PDT), a minimally invasive treatment with reduced phototoxicity, which has been increasingly utilized since its approval in Japan.

Methods: This retrospective study at the Nagoya City University Hospital (May 2016-December 2023) assessed the efficacy of TS-PDT for esophageal cancer after CRT or radiotherapy in 29 patients who met specific inclusion criteria. The evaluated outcomes included adverse events, local complete response (L-CR), progression-free survival (PFS), and overall survival (OS).

Results: Among the patients (23 men and 6 women; median age, 72 years), TS-PDT achieved an L-CR rate of 81.5% per patient and 87.8% per lesion, with a higher success rate against T1b lesions. The median local PFS was 44.1 months, and OS had not yet been reached, with a 1-year survival rate of 91.9%. The adverse events included esophageal strictures and perforations.

Conclusion: TS-PDT is a potentially effective salvage treatment for ESCC, offering efficient local control and favorable survival outcomes. Despite some adverse events, its reduced phototoxicity and versatility make it a viable option, particularly for elderly patients. Further multicenter trials are warranted to validate its role in esophageal cancer management.