Evaluation of Photodynamic Therapy for Gastric Cancer

Mimura, Seishiro; Ichii, Makoto; Imanishi, Kiyoshi; Tatsuta, Masaharu; Otani, Torn; Okuda, Shujiro

doi:10.1111/j.1443-1661.1990.tb00051.x

Cited by 13 publications

(6 citation statements)

References 22 publications

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“…8 Regarding PDT for gastric cancer, PDT with Photofrin and an argon dye laser (ADL) are prevalent all over the world. In1990, Mimura et al 9 reported that PDT using HpD and ADL induced 58% CR rate without recurrence (21/36) in EGC patients. As far as we search, this is the most favorable outcome about gastric PDT using ADL.…”

Section: Discussionmentioning

confidence: 97%

“…Although PDT has become one of the recognized therapeutic modalities for malignant tumors, 9 with further development, this minimally invasive treatment may offer another therapeutic option in the setting of the increasing elderliness. 13 In the era of ESD, Photofrin-PDT should be applied not only EGC patients who are excluded from ESD treatment and have not been cured by ESD with poor risk for surgery, and have high possibilitiy to be cured by PDT, but also advanced cancer patients for local improvement of lesions combined with other treatment modalities.…”

Section: Discussionmentioning

confidence: 99%

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Photofrin-PDT for gastric cancer in the era of endoscopic submucosal dissection

et al. 2009

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Background: Endoscopic mucosal resection (EMR) was originated to treat early gastric cancer (EGC). EMR was suitable for small, mucosal and well-differentiated adenocarcinoma without ulceration. It was difficult to resect larger tumors en bloc by this method. In recent years, a more useful method, endoscopic submuscosal dissection (ESD) has been developed, which enables en bloc resection of large mucosal lesions. On the contrary, photodynamic therapy (PDT) is applicable to submucosal, poorly differentiated, or carcinoma with ulceration. In the era of ESD, we evaluated the value of Photofrin-PDT. Patients & Methods: We applied PDT to 36 patients including three advanced cancers, who had been excluded from EMR (ESD) and were at high risks for surgery or refused surgery. Four EGC patients who had not been cured by EMR (ESD) were included. Our PDT procedure consisted of polyhematoporphyrin ether/ester administration (Photofrin, 2 mg/Kg) and pulsed excimer dye laser irradiation at 630 nm 48 hours (and 96 hours) after sensitization. Results: Complete response (CR) at three months was obtained in 84% (21/25) of mucosal cancer and in 50% (4/8) of submucosal cancer. Although three patients with an advanced cancer improved but were not cured, quality of their life was maintained. There were no serious side effects except skin photosensitivity. Conclusion: Photofrin-PDT should be applied not only EGC patients who are excluded from ESD and have not been cured by ESD with poor risk for surgery, and have high possibilitiy to be cured by PDT, but also advanced cancer patients for local improvement of lesions.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Photofrin-PDT for gastric cancer in the era of endoscopic submucosal dissection

et al. 2009

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“…Although the effect of irradiation for cell destruction has been studied in vitro [10,11], few clinical data have been reported on the relationship between irradiation dosage and tissue destruction, especially in the stomach. In previous studies [7,12], irradiation dosages ranging from 60 J/cm 2 to 150 J/cm 2 have been used for PDT of gastric cancer. However, whether or not such dosages are adequate needs to be confirmed again, as the area of irradiation may be miscalculated.…”

Section: Discussionmentioning

confidence: 99%

Shape-Memory Alloy Loop Snare for Endoscopic Photodynamic Therapy of Early Gastric Cancer

Nakamura¹,

Fukui²,

Ishii³

et al. 2000

Endoscopy

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“…Although it is impossible to prove that cancer was completely cured based on clinical examinations, our definition of 'cure' was when neither local recurrence nor metastasis were detected by follow-up examinations at year. Cases classified as partial response and recurrence after year, therefore, were classified as 'no cure' in our evaluation [9].…”

Section: Evaluation Of Responsementioning

confidence: 99%

Progress of Photodynamic Therapy in Gastric Cancer

Mimura

Narahara

Otani

et al. 1999

Diagnostic and Therapeutic Endoscopy

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Progress of photodynamic therapy (PDT) in gastric cancer and the clinical outcome are described in this paper. (1) We included the whole lesion and a 5 mm margin in the field for irradiation. Marking by injection of India-ink showing the irradiation field was performed beforehand. (2) We established the standard light dose to be 90 J/cm2 for an argon dye laser and 60 J/cm2 for a pulse wave laser. (3) The size of cancerous lesion curable by PDT was expanded from 3 cm in diameter, i.e. 7 cm2 in area to 4 cm in diameter, i.e. 13 cm2 by employing a new excimer dye laser model, which could emit 4mJ/pulse with 80 Hz pulse frequency. (4) The depth of cancer invasion which could be treated by PDT was increased from about 4 mm, i.e. the superficial part of the submucosal layer (SM-1) to more than 10 mm in depth, i.e. the proper muscular layer. These improvements owe much to the pulse laser, the photodynamic action induced by which permits deeper penetration than that of a continuous wave laser. (5) We employed a side-viewing fiberscope for gastric PDT to irradiate the lesion from an angle of 90°. (6) We designed a simple cut quartz fiber for photoradiation with a spiral spring thickened toward the end. (7) We developed an endoscopic device for photoradiation in PDT which achieves accurate and efficient irradiation. As a result of these improvements a higher cure rate was obtained even with a lower light dose of irradiation.

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Evaluation of Photodynamic Therapy for Gastric Cancer

Cited by 13 publications

References 22 publications

Photofrin-PDT for gastric cancer in the era of endoscopic submucosal dissection

Photofrin-PDT for gastric cancer in the era of endoscopic submucosal dissection

Shape-Memory Alloy Loop Snare for Endoscopic Photodynamic Therapy of Early Gastric Cancer

Progress of Photodynamic Therapy in Gastric Cancer

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