Photodynamic therapy in esophageal cancer

Abstract

Historically, photodynamic therapy was an additional mechanism, along with external beam irradiation or brachytherapy, Nd:YAG laser tumor ablation or esophageal stent placement and to a lesser extent, chemotherapy, used to reestablish esophageal continuity in patients with esophageal malignancy who could not undergo resective surgery by virtue of infirmity or tumor stage.However, it has been virtually abandoned for this indication by most practitioners for over a decade.More recently, it has been used in the West to eradicate high-grade dysplasia and superficial malignancies arising in Barrett's esophagus, although its expense, limited availability, and side effect profile make widespread use unlikely, particularly given the widespread availability of other effective techniques.The latter include endoscopic submucosal resection, endoscopic submucosal dissection, radiofrequency ablation, and cryotherapy.This review highlights the historical use of photodynamic therapy in the treatment of esophageal malignancy and potential roles for its application in the future.