The potential of photodynamic therapy to treat esophageal candidiasis coexisting with esophageal cancer

• Photodynamic therapy (PDT) is a promising esophageal cancer treatment, but has not been reported for GI fungal infections.
• Two patients had esophageal candidiasis coexisting with esophageal cancer were treated by PDT.
• The esophageal candidiasis of these two patients were cured by PDT without serious adverse events.
• The esophageal cancer of the two patients were also cured or reached partial response after PDT.

BackgroundPhotodynamic therapy (PDT) has been used in recent years to deal with fungal infections because of the prevalence of fungi resistance to drugs. However, PDT for gastrointestinal fungal infection has not been reported. This study was conducted to assess the potential of PDT to deal with esophageal candidiasis.MethodsTwo male patients with histological evidence of esophageal candidiasis coexisting with esophageal cancer were included in this retrospective study. Both patients were treated with PDT. This treatment was repeated at least 1 month after the initial PDT if the patient still had residual cancer or esophageal candidiasis. Short-term efficacy was evaluated on the basis of endoscopy and histology findings. Further follow-up data were obtained from endoscopy results or telephone conversation.ResultsThe esophageal candidiasis located 21–24 cm and 25–28 cm from the incisors of case 1 reached complete remission after one and two PDT sessions, respectively. The esophageal cancer coexisting with esophageal candidiasis located 21–24 cm from the incisors reached complete remission after two PDT sessions. No recurrence was found at a 14-month follow-up. The esophageal cancer located 30–35 cm from the incisors reached partial response after three PDT sessions. Both of the esophageal candidiasis and the coexisting esophageal cancer at 23–26 cm from the incisors of case 2 reached complete remission and the esophageal cancer at 34–37 cm from the incisors reached complete remission after one PDT session. No recurrence was found at a 24-month follow-up. There were no serious adverse events found in either of the two cases.ConclusionResults of this preliminary study indicate that PDT may be a potential method to deal with esophageal candidiasis.