Results of intraoperative photodynamic therapy (IOPDT) in patients with gastric cancer are represented in the article. The study included 240 patients with gastric cancer stage II-IV (Т3-4N0-3M0-1) with evident or suspected peritoneal dissemination who underwent examination and treatment in P.Herzen Moscow Oncology Research Institute. The group 1, the study group, included 140 patients who underwent nominally curative or palliative surgery for locally advanced and disseminated gastric cancer with IOPDT as additional intraoperative intervention for antiblastics and cancer treatment. The group 2, the control group, included 100 patients who also underwent nominally curative or palliative surgery (equal to extent of surgery in patients from the study group) for locally advanced and disseminated gastric cancer and no intraoperative implication of physical or chemical treatment methods. IOPDT did not worsen a course of early post-operative period, did not impact on severity of post-operative complications and was not associated with increase of post-operative mortality. IOPDT allowed for improvement of 1-year and 3-year disease-specifi c survival rates: by 16.1% and 16.7%, respectively. For nominally curative resections, median survival, 1- year and 3-year disease-specifi c survival rates were improved by 14 months, 17.8% and 31.3%, respectively. For R1, R2 resections, IOPDT improved 1-year disease-specifi c survival rates by 16.4%. Additionally, for nominally curative resections IOPDT did not increase the recurrence rate and improved median recurrence-free survival, 1-year and 3-year recurrence-free survival rates by 16 months, 27.2% and 25.4%, respectively.
New medical technology of photodynamic therapy for cancer of hollow organs with photosens determines parameters of irradiation (sites of placement and position of light guide, number of positions and duration of irradiation) to reduce probability of injury during irradiation of intact mucosa in hollow organ due to optimization of light dose. The technology allows to avoid inflammatory and necrotic injury of intact mucosa on the contralateral wall of organ and late complications and to achieve complete tumor regression depending on localization in 73–87% of cases for follow-up period from 1 to 11 years.
A case of multiple course of photodynamic therapy (PDT) in patient with gastric cancer T 1 N 0 M 0 . Morpholological diagnosis in this patient was signet ring cell cancer. For 8 years the patient underwent endoscopic organ-sparing treatment: PDT with Photohem (17 courses), electrocoagulation of tumor (3 sessions). The drug Photohem was introduced intravenously at dose of 3.0 mg/kg body weight for 48 h before PDT. The treatment result was only partial regression of gastric tumor, the maximal follow-up period with no endoscopic and morphological signs of tumor growth accounted for 8 months. However besides incomplete removal of gastric tumor and morphological type, for check-up examination 8 years after the onset of endoscopic treatment there were no features of regional and distant metastases according to chest and abdominal CT and US.