Successful sphincter preservation and long-term survival in a patient with ultra-low locally advanced rectal cancer treated with photodynamic therapy combined with multimodal treatment: a case report and literature review

Ultra-low locally advanced rectal cancer presents significant challenges for sphincter-preserving surgery due to its anatomical constraints and limited response to conventional neoadjuvant therapies. This case report describes a patient diagnosed with stage IIIb (cT3N2M0) ultra-low rectal cancer who...

Full description

Saved in:
Bibliographic Details
Main Authors: Dan Zou, Baohong Gu, Yifan Li, Ying Yan, Huanhuan Ma, Kai Wang, Weiyi Chen, Bofang Wang, Hao Chen
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Therapeutic Advances in Medical Oncology
Online Access:https://doi.org/10.1177/17588359251345927
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850113877781512192
author Dan Zou
Baohong Gu
Yifan Li
Ying Yan
Huanhuan Ma
Kai Wang
Weiyi Chen
Bofang Wang
Hao Chen
author_facet Dan Zou
Baohong Gu
Yifan Li
Ying Yan
Huanhuan Ma
Kai Wang
Weiyi Chen
Bofang Wang
Hao Chen
author_sort Dan Zou
collection DOAJ
description Ultra-low locally advanced rectal cancer presents significant challenges for sphincter-preserving surgery due to its anatomical constraints and limited response to conventional neoadjuvant therapies. This case report describes a patient diagnosed with stage IIIb (cT3N2M0) ultra-low rectal cancer who had a strong preference for sphincter preservation. Given the suboptimal efficacy of standard treatments in achieving sufficient tumor downstaging, a comprehensive 6-month neoadjuvant regimen was implemented, combining photodynamic therapy (PDT), chemotherapy, targeted therapy, and immunotherapy. PDT selectively induced tumor necrosis, disrupted the tumor vasculature, enhanced therapeutic agent penetration, and transformed the tumor microenvironment into an immune-responsive state. This multimodal approach resulted in significant tumor regression, facilitating sphincter-preserving radical resection. Postoperative pathological examination confirmed a pathological complete response, and the patient remains disease-free, with a progression-free survival exceeding 48 months. This case highlights the potential of a multimodal treatment approach, combining PDT with systemic therapies, to enhance tumor downstaging, potentiate the efficacy of immunotherapy, and improve sphincter preservation rates in ultra-low locally advanced rectal cancer. This integrated strategy offers a promising approach for optimizing clinical outcomes in these challenging cases.
format Article
id doaj-art-a8e386a95b34448dba60f701080d716e
institution OA Journals
issn 1758-8359
language English
publishDate 2025-06-01
publisher SAGE Publishing
record_format Article
series Therapeutic Advances in Medical Oncology
spelling doaj-art-a8e386a95b34448dba60f701080d716e2025-08-20T02:37:02ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592025-06-011710.1177/17588359251345927Successful sphincter preservation and long-term survival in a patient with ultra-low locally advanced rectal cancer treated with photodynamic therapy combined with multimodal treatment: a case report and literature reviewDan ZouBaohong GuYifan LiYing YanHuanhuan MaKai WangWeiyi ChenBofang WangHao ChenUltra-low locally advanced rectal cancer presents significant challenges for sphincter-preserving surgery due to its anatomical constraints and limited response to conventional neoadjuvant therapies. This case report describes a patient diagnosed with stage IIIb (cT3N2M0) ultra-low rectal cancer who had a strong preference for sphincter preservation. Given the suboptimal efficacy of standard treatments in achieving sufficient tumor downstaging, a comprehensive 6-month neoadjuvant regimen was implemented, combining photodynamic therapy (PDT), chemotherapy, targeted therapy, and immunotherapy. PDT selectively induced tumor necrosis, disrupted the tumor vasculature, enhanced therapeutic agent penetration, and transformed the tumor microenvironment into an immune-responsive state. This multimodal approach resulted in significant tumor regression, facilitating sphincter-preserving radical resection. Postoperative pathological examination confirmed a pathological complete response, and the patient remains disease-free, with a progression-free survival exceeding 48 months. This case highlights the potential of a multimodal treatment approach, combining PDT with systemic therapies, to enhance tumor downstaging, potentiate the efficacy of immunotherapy, and improve sphincter preservation rates in ultra-low locally advanced rectal cancer. This integrated strategy offers a promising approach for optimizing clinical outcomes in these challenging cases.https://doi.org/10.1177/17588359251345927
spellingShingle Dan Zou
Baohong Gu
Yifan Li
Ying Yan
Huanhuan Ma
Kai Wang
Weiyi Chen
Bofang Wang
Hao Chen
Successful sphincter preservation and long-term survival in a patient with ultra-low locally advanced rectal cancer treated with photodynamic therapy combined with multimodal treatment: a case report and literature review
Therapeutic Advances in Medical Oncology
title Successful sphincter preservation and long-term survival in a patient with ultra-low locally advanced rectal cancer treated with photodynamic therapy combined with multimodal treatment: a case report and literature review
title_full Successful sphincter preservation and long-term survival in a patient with ultra-low locally advanced rectal cancer treated with photodynamic therapy combined with multimodal treatment: a case report and literature review
title_fullStr Successful sphincter preservation and long-term survival in a patient with ultra-low locally advanced rectal cancer treated with photodynamic therapy combined with multimodal treatment: a case report and literature review
title_full_unstemmed Successful sphincter preservation and long-term survival in a patient with ultra-low locally advanced rectal cancer treated with photodynamic therapy combined with multimodal treatment: a case report and literature review
title_short Successful sphincter preservation and long-term survival in a patient with ultra-low locally advanced rectal cancer treated with photodynamic therapy combined with multimodal treatment: a case report and literature review
title_sort successful sphincter preservation and long term survival in a patient with ultra low locally advanced rectal cancer treated with photodynamic therapy combined with multimodal treatment a case report and literature review
url https://doi.org/10.1177/17588359251345927
work_keys_str_mv AT danzou successfulsphincterpreservationandlongtermsurvivalinapatientwithultralowlocallyadvancedrectalcancertreatedwithphotodynamictherapycombinedwithmultimodaltreatmentacasereportandliteraturereview
AT baohonggu successfulsphincterpreservationandlongtermsurvivalinapatientwithultralowlocallyadvancedrectalcancertreatedwithphotodynamictherapycombinedwithmultimodaltreatmentacasereportandliteraturereview
AT yifanli successfulsphincterpreservationandlongtermsurvivalinapatientwithultralowlocallyadvancedrectalcancertreatedwithphotodynamictherapycombinedwithmultimodaltreatmentacasereportandliteraturereview
AT yingyan successfulsphincterpreservationandlongtermsurvivalinapatientwithultralowlocallyadvancedrectalcancertreatedwithphotodynamictherapycombinedwithmultimodaltreatmentacasereportandliteraturereview
AT huanhuanma successfulsphincterpreservationandlongtermsurvivalinapatientwithultralowlocallyadvancedrectalcancertreatedwithphotodynamictherapycombinedwithmultimodaltreatmentacasereportandliteraturereview
AT kaiwang successfulsphincterpreservationandlongtermsurvivalinapatientwithultralowlocallyadvancedrectalcancertreatedwithphotodynamictherapycombinedwithmultimodaltreatmentacasereportandliteraturereview
AT weiyichen successfulsphincterpreservationandlongtermsurvivalinapatientwithultralowlocallyadvancedrectalcancertreatedwithphotodynamictherapycombinedwithmultimodaltreatmentacasereportandliteraturereview
AT bofangwang successfulsphincterpreservationandlongtermsurvivalinapatientwithultralowlocallyadvancedrectalcancertreatedwithphotodynamictherapycombinedwithmultimodaltreatmentacasereportandliteraturereview
AT haochen successfulsphincterpreservationandlongtermsurvivalinapatientwithultralowlocallyadvancedrectalcancertreatedwithphotodynamictherapycombinedwithmultimodaltreatmentacasereportandliteraturereview