[Photodynamic therapy for esophageal cancer]

Evaluation of resected cases of esophageal superficial cancer have shown that lymph node metastasis was absent, and radical local treatment would be possible for m1 and m2 cancer. However, the depth of cancer invasion is difficult to diagnose before treatment. Endoscopic mucosal resection (EMR) is useful for not only treating but also diagnosing cancer. Therefore, EMR is recommended as the treatment of choice for m1 or m2 lesions. On the other hand, treatment of esophageal superficial cancer by PDT is effective even for deep sm cancers. In particular, the use of excimer dye laser increases light transmittance, there by improving the treatment results for sm cancer. EMR was not effective for treating sm cancer or diagnosing the depth of its invasion. In sm cancer, since lymph node metastasis is observed in 30-50% of the cases, local treatment cannot be radical. Therefore, PDT is best indicated as a local treatment for sm cancer that cannot be treated by operation. Local healing after PDT prevents dysphagia caused by stenosis due to cancer, which may allow medical management at home.