Pathologic complete response after photodynamic therapy combined with dose-reduction chemoradiotherapy in elderly patient with severe obstruction esophageal carcinoma: A case report

Esophageal Carcinoma (EC) is one of the most aggressive gastrointestinal cancers. Advanced esophageal carci-noma is associated mainly with dysphagia which reduces the quality of life and leads to frail in patients even difficult to tolerate systemic treatments such as surgery and chemoradiotherapy. Moreover, chemoradiotherapy (CRT)cannot relieve dysphagia in a short time especially for the elderly patient with comorbidities. Here, we report a 76-year-old female patient diagnosed with severe obstructive esophageal squamous cell carcinoma (ESCC) that endoscope could not pass through. She was also complicated with bilateral interstitial pneumonia and moderate pulmonary ventilation dysfunction. The patient was unable to undergo surgery and radical CRT. After multidisciplinary team (MDT) discussion, we gave the patient photodynamic therapy (PDT) treatment firstly. The obstruction was significantly improved within 1 week and normal diet was resumed after 2 weeks. Four weeks later, considering bilateral interstitial pneumonia, concurrent dose-reduction chemoradiotherapy was given for esophageal lesions and abdominal metastatic lymph nodes. There was no recurrence and pro-gression in the esophagus and abdominal lymph nodes until now and the biopsy of the primary esophageal lesion showed pathologic complete response. Now, the patient is still under regular follow-up.

Automated summary

Esophageal carcinoma (EC) is a highly aggressive gastrointestinal cancer. Dysphagia is the main symptom of advanced EC, which leads to reduced quality of life and difficulty in tolerating systemic treatments. This report presents a case of a 76-year-old female patient with severe obstructive esophageal squamous cell carcinoma (ESCC) and bilateral interstitial pneumonia. Due to her age and comorbidities, the patient was unable to undergo surgery and radical chemoradiotherapy. After multidisciplinary team discussion, photodynamic therapy (PDT) was administered, resulting in significant improvement of the obstruction within 1 week and resumption of a normal diet after 2 weeks. Four weeks later, concurrent dose-reduction chemoradiotherapy was given for esophageal lesions and abdominal metastatic lymph nodes. To date, there has been no recurrence or progression in the esophagus and abdominal lymph nodes, and biopsy of the primary esophageal lesion showed pathologic complete response. The patient is currently under regular follow-up.