P1.128. Talaporfin Sodium Photodynamic Therapy for Locally Recurrent Esophageal Squamous Cell Carcinoma After Chemoradiotherapy

Topic Esophageal Cancer: Oncology/Radiation Therapy Background Local recurrence after chemoradiotherapy remains a major challenge in esophageal squamous cell carcinoma. Salvage surgery is invasive and often unsuitable for elderly or high-risk patients. Talaporfin sodium photodynamic therapy offers a minimally invasive alternative. This study evaluated its clinical efficacy and safety in locally recurrent or residual disease. Methods A retrospective analysis was performed on 29 patients with histologically confirmed locally recurrent or residual esophageal squamous cell carcinoma after chemoradiotherapy or radiotherapy. Eligible lesions were ≤T2 without lymph node or distant metastasis. Talaporfin sodium (40 mg/m2) was administered intravenously, followed by diode laser irradiation (664 nm) 4–6 hours later. Patients were assessed for local complete response, progression-free survival, overall survival, and treatment-related adverse events. Survival outcomes were estimated using Kaplan–Meier analysis. Clinical outcomes were compared between patients treated with single and multiple photodynamic therapy sessions. Results The local complete response rate was 82.1% per patient and 87.8% per lesion. Response was higher in T1b lesions (96.6%) than in T2 lesions (66.7%). Median local progression-free survival was 1,324 days, and median progression-free survival was 912 days. Three-year overall survival was 70.7%. Patients treated with a single session demonstrated higher 3-year overall survival than those requiring multiple sessions (83.3% vs 44.4%). No skin phototoxicity occurred. Adverse events included one asymptomatic esophageal stricture and two esophageal perforations, one requiring surgical intervention. Conclusion Talaporfin sodium photodynamic therapy achieved high local control with acceptable safety in locally recurrent esophageal squamous cell carcinoma after chemoradiotherapy. Its minimally invasive nature and low phototoxicity make it particularly suitable for elderly or high-risk patients. Repeat treatment capability supports its role as a flexible salvage strategy. Prospective multicenter studies are warranted to further validate long-term outcomes.