Current role of laser and photodynamic therapy in gastrointestinal tumors and analysis of a 10‐year experience

Spinelli, P; Fante, Marco Dal; Mancini, Andrea

doi:10.1002/ssu.2980080405

Cited by 14 publications

(14 citation statements)

References 49 publications

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“…High cure rates for benign colon adenomas have been reported with laser therapy in many studies. [16][17][18][19] Endoscopic treatment of asymptomatic non-neoplastic stenosis is one indication for high-power laser therapy. Kiefhaber 18 and Sander and Posel 20 have shown that the high-power laser is effective in opening strictures of E 0 * Significant difference between before and after laser therapy, by Wilcoxson matched-pairs signed-rank test, one-tailed (P Ͻ 0.001) A, The patient is able to eat a solid or normal diet B, The patient is able to take a semiliquid diet smoothly C, The patient is able to drink water or fluid food well D, The patient has difficulty in swallowing a liquid diet and has frequent vomiting E, The patient fails to swallow any food and has vomiting Stenotic lumen impassible by endoscope (lumen Ͻ 9 cm) Before treatment 10 34.5 After treatment 2 6.9…”

Section: Discussionmentioning

confidence: 99%

Low-power laser therapy for gastrointestinal neoplasia

Tsao

Shyu

2000

Journal of Gastroenterology

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The purpose of this study was to evaluate changes in the degree of neoplasia-induced stenosis and clinical symptoms before and after therapy with a contact low-power neodymium yttrium aluminum garnet (Nd:YAG) laser. Fifty patients with pathologically proven gastrointestinal (GI) neoplasia were studied; 21 with benign lesions and 29 with malignant tumors. The low-power contact Nd:YAG laser was applied toward the lesion, using an antegrade method as the scope was moved circumferentially and downward along the length of the lesions, step-by-step. The energy of the laser was 20W, with a duration of 1 to 2 min for each shot. Either the tumor was eradicated completely, or the neoplasia-induced stenosis was recanalized by laser via the endoscope. All benign lesions were completely remitted by laser therapy. The clinical symptoms in the 29 patients with malignant GI neoplasia showed a significant improvement (P < 0.001; Wilcoxon matched-pairs signed-rank test, one-tailed) after laser therapy in comparison with the symptoms before treatment. Malignant GI stenosis treated by laser resulted in recanalization in 93.1% of the 29 patients. Unfortunately, in 1 patient with gastric cancer, the disease progressively worsened after treatment. One of 3 patients with early cancer of the stomach who received laser therapy was found to have distant metastasis 2 years later. A patient with esophageal cancer developed an esophagobronchial fistula that was not a direct complication of the laser effect. Four patients with malignancies died of cancer progression during the 2 years of follow-up. We conclude that the low-power contact laser is a safe, convenient method for the treatment of both benign and malignant tumors. Patients with advanced obstructive lesions have a better quality of life after laser therapy.

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Section: Discussionmentioning

confidence: 99%

Low-power laser therapy for gastrointestinal neoplasia

Tsao

Shyu

2000

Journal of Gastroenterology

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“…125 ''Unequivocal visible changes and necrosis'' 125 were noted, the treatment was repeated 6 months later with apparent clinical success, and others have noted similar results. 123,126,127 More recent studies have used colon cell cultures to test new PDT techniques. 128 Del Governatore et al used a photoimmunoconjugate of an anticolon cancer monoclonal antibody with the chlorin photosensitizer NPe6.…”

Section: Pdt For Colorectal Cancermentioning

confidence: 99%

Uses of Photodynamic Therapy in Premalignant and Malignant Lesions of the Gastrointestinal Tract Beyond the Esophagus

Wolfsen¹

2005

Journal of Clinical Gastroenterology

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Much has recently been written regarding the use of photodynamic therapy for the treatment of esophageal carcinoma and dysplastic Barrett's esophagus. This review, however, describes the clinical experience using photodynamic therapy with various photosensitizer agents for the treatment of diseases in other areas of the gut, especially the pancreaticobiliary tract where European studies have established the role of porfimer sodium photodynamic therapy in the management of patients with cholangiocarcinoma.

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“…PDT has been used to treat superficial esophageal cancer, early lung cancer and early gastric cancer (4)(5)(6). In gynecology, PDT has been used to treat early cancer of the cervix (7).…”

Section: Introductionmentioning

confidence: 99%

Differences in the sensitivity of ovarian cancer to photodynamic therapy and the mechanisms for those differences

et al. 2017

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Abstract. Protoporphyrin IX (PpIX) levels are crucial to the antitumor action of photodynamic therapy (PDT). In the present study, the underling molecular mechanisms for the variation in PpIX levels in ovarian cancer cells were investigated. Five ovarian cancer cell lines were subcutaneously grafted onto the backs of nude mice. Once tumors had developed, 5-aminolevulinic acid methyl ester hydrochloride (methyl-ALA) was administered intraperitoneally and the tumor was irradiated twice/week. PpIX levels in the tumor were assayed using high-performance liquid chromatography. Enzymes involved in heme synthesis and degradation were screened using a microarray technique. Expression of the glutathione transferase Omega-1 (GSTO1) gene involved in the conversion of PpIX into heme in cells was quantified using the reverse transcription-quantitative polymerase chain reaction. In HTOA, HRA and DISS cells, PDT resulted in significant tumor shrinkage in comparison with the controls. In MCAS and TOV21G cells, no significant alterations in tumor growth were identified compared with the untreated cells. PpIX levels increased significantly in HTOA, DISS and HRA cells compared with in MCAS and TOV21G cells. A comparison of genetic profiles using PDT-sensitive DISS cells and PDT-resistant MCAS cells indicated that MCAS cells exhibited significantly increased levels of δ-aminolevulinate synthase (a rate-limiting enzyme in heme synthesis), heme oxygenase 2 (an enzyme that degrades heme into biliverdin), and biliverdin reductase B (an enzyme that reduces biliverdin into bilirubin) in comparison with DISS cells. The level of GSTO1 expression in HTOA, HRA and DISS cells was ~2.5-fold that in MCAS and TOV21G cells. Sensitivity to PDT is related to PpIX levels in cells. The results of the present study suggested that PpIX tends not to accumulate in PDT-resistant cells despite active heme synthesis and degradation, and that high levels of GSTO1 expression are associated with increased sensitivity to PDT. IntroductionThe standard treatment for ovarian cancer is surgery followed by anticancer therapy (1). A total of ~70% of advanced ovarian cancer recurs, so advanced ovarian cancer ultimately has a 5-year survival rate of between 30 and 40% (2). Ovarian cancer has the highest mortality rate among gynecological malignancies (3).Photodynamic therapy (PDT) has garnered attention as a novel therapy to reduce the tumor burden on a patient. PDT has been used to treat superficial esophageal cancer, early lung cancer and early gastric cancer (4-6). In gynecology, PDT has been used to treat early cancer of the cervix (7). Younger patients tend to opt to receive treatment that preserves fertility, and PDT may be such a treatment (7). Therefore, attention has focused on the usefulness of PDT in that regard. Unlike conventional approaches, PDT leaves the cervix intact, has a high cure rate, and does not hamper pregnancy or delivery following surgery (7).PDT is a therapy involving photosensitizers (or their precursors) with an affinity for tumors. The sp...

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Current role of laser and photodynamic therapy in gastrointestinal tumors and analysis of a 10‐year experience

Cited by 14 publications

References 49 publications

Low-power laser therapy for gastrointestinal neoplasia

Low-power laser therapy for gastrointestinal neoplasia

Uses of Photodynamic Therapy in Premalignant and Malignant Lesions of the Gastrointestinal Tract Beyond the Esophagus

Differences in the sensitivity of ovarian cancer to photodynamic therapy and the mechanisms for those differences

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