Long-term results after photodynamic therapy (PDT) of T1N0M0 gastrointestinal (GI) tumors

Background/Aims: Photodynamic therapy is a potentially curative method with the best cost/effectiveness ratio in early stage tumors. A two-phase study on long-term results of photodynamic therapy for T1N0M0 gastrointestinal tumors was started in 1988: the first phase was connected with application of pure hematoporphyrin Hp/5 (Italy) while the second one was associated with application of a Bulgarian hematoporphyrin derivative HEMATODREX. The aim of the study is to report the 5 and 10-year survival. Methodology: Patients under study should never received any kind of antitumor and immunostimulant treatment prior to photodynamic therapy or,in the course of the follow-up. Any cause of deaths in patients under study should be confirmed by a hospital autopsy protocol. Follow-up until the end of the 5th year was carried out by means of regular check ups, while between the 5th and the 10th year by means of yearly questionnaires by mail. Thirteen cases entirely fulfilled the requirements of the study, 10 cases in the first phase and three cases in the second one. Results: Crude survival rate was 128.0 months (approx. 10 years and 8 months) and the cancer-related mortality reached 7.7%. Three-year survival reached 100.0% while the 5-year survival was 92.3%. Longest survival was observed in the first phase-163.0 months (approx. 13 years and 7 months) with cancer-related death rate of 10.0%. The second phase group is still under follow-up with a promise for better results. Conclusions: The future belongs to real radical photodynamic therapy used in early stages as a more natural and organ-preserving method.