Photodynamic Therapy of Esophagogastric Tumor with Intra-Tumoral Injection of Hematoporphyrin Derivative

From January 1988 to June 1989, twelve patients with endoscopically proven esophagogastric tumor were accepted for photodynamic therapy (PDT) at Taipei Municipal Jen-Ai Hospital for a total of 26 sessions. To avoid undesirable systemic photosensitization side effects, an intra-tumorous dose of 10-20mg (approximately 5mg/cm^2) hematoporphyrin derivative (HpD) was given during the endoscopy. Two or three days after the HpD injection, the tumor areas were photoradiated with 630 nm light with a total energy density of 120 J/cm^2. The procedure was repeated at 7 day intervals until the tumor was no longer visible or was remarkably reducd in size. The overall response rate to this therapeutic effect was 83% with satisfactory effect at 58%. In this series, 5 cases were diagnosed in the early stages of cancer. After treatment, 3 cases responded completely and 2 cases partially. During the entire course, no systemic photosensitization or severe complications were observed. Our preliminary results suggest that local photosensitization by HpD could be used as a therapy modality for treatment of neoplastic esophagogastric lesions although it will have to be confirmed by a larger number of cases and follow up a longer period.