Photodynamic therapy of skin and esophageal cancers

We report on 27 patients with cutaneous and subcutaneous malignancies and 40 patients with esophageal tumors treated with photodynamic therapy (PDT). Of those patients treated for skin tumors, seven had basal cell, three squamous cell, three malignant melanoma, one liposarcoma, and twelve had breast cancers. One patient had Bowen's disease. Treatment was given either by surface radiation or interstitially. One month after treatment, 48 (67%) of the treatment sessions resulted in a complete response (no clinical evidence of tumor) and 19 (26%) resulted in a partial response (more than a 50% reduction in the number or size of tumors). Of the 15 patients evaluable 12 months after treatment, 31 treatment sessions were evaluated as complete response 1 month after therapy, 15 (48%) of which retained this status at 1 year posttreatment. Esophageal tumors were as follows: 19 adenocarcinomas, 19 squamous carcinomas, and 2 melanomas. Most patients were reendoscoped 2 to 3 days after PDT and repeat endoscopies were performed 1 month after PDT and as needed when symptoms recurred. The goal of therapy was to improve the patient's ability to swallow. At 1 month, the average length of all tumors decreased from 7.0 to 6.1 cm, and the average minimal diameter opening increased from 6 to 9 mm. Of the 35 patients who were evaluable 1 month after PDT, the average diet grade improved from 16 to 32 (i.e., improvement in food intake from a liquid to a soft diet).