Background: Among total
cancer deaths,
esophageal cancer ranks sixth in mortality.
Radiotherapy and
chemotherapy remain the main treatments for unresectable, locally advanced
esophageal cancer, but a relapse and drug resistance are still common. The optimized choice for therapeutic schemes with low toxicity and a high quality of life is unclear when local progression occurs after
radiotherapy and
chemotherapy. Fluoroscopy-guided
photodynamic therapy (
PDT) on patients with recurrent
esophageal cancer in whom the
endoscope cannot pass may be used as a
salvage treatment, and nanoparticle
albumin-bound paclitaxel (Nab-P) has been shown to be effective for advanced
esophageal cancer. The combination of
PDT and Nab-P might be an effective and tolerable option for advanced
esophageal cancer. Case summary: The authors present a 65-year-old male patient diagnosed with
esophageal squamous cell carcinoma (ESCC) confirmed to have developed local progression after receiving
radiotherapy and
chemotherapy. Severe
esophageal stenosis, mild
malnutrition and
anemia, and
radiation pneumonia were found when he was admitted to the authors' hospital. For rapid reduction of
tumor burden and to restore normal diet, he received
PDT by the X-ray fluoroscopy positioning method and Nab-P
chemotherapy. The patient obtained clinical benefit from these treatments, and improved his quality of life. Conclusions: This case demonstrates potential advantages of fluoroscopy-guided
PDT combined with Nab-P in reducing the
tumor load, preserving organ function, and improving the quality of life, as well as the beneficial effect on locally advanced
esophageal cancer after
radiotherapy and
chemotherapy. This combination
therapy provides an alternative for the clinical treatment of locally advanced
esophageal cancer and it has broad prospects in treatment of the disease. Core tip: Herein, the authors report a case of a patient with ESCC who suffered locally progressive disease after
chemotherapy and
radiotherapy as well as
malnutrition and mild
anemia because of feeding difficulties. The patient was treated with
PDT, which was assisted by a new positioning technique of X-ray fluoroscopy and Nab-P
chemotherapy, and finally achieved clinical benefits. In addition, a modified transnasal
feeding tube was also applied in the process of fluoroscopy-guided
PDT in this article.