Photodynamic Therapy as a Component of Preoperative Preparation for Patients With Stomach Cancer

Abstract

The study and analysis of the treatment outcomes were carried out in 69 patients aged from 40 to 85 years (mean age 53.0±1.0) who had tumours of the body or cardiac part of the stomach T3-4 (according to the UICC classification (ninth edition, 2014)). The distribution of patients according to the localization of tumour lesions in the stomach was as follows: 43 (62.3%) cases found in the body region and 22 (31.9%) found in the proximal section (of which 14 (20 3%) were in the cardia (Type III according to Siewert J.R.), 8 (11.6%) patients had the transition to the abdominal oesophagus (type II according to Siewert JR), 4 (5.8%) patients had the tumour located in the stump of the resected organ. Histologically, the vast majority of neoplasms were represented by adenocarcinoma (94.8%). All other types of tumours made up for 5.2%. The patients received photodynamic therapy with the Photolon photosensitizer and subsequent irradiation with a laser with a wavelength λ = 0.67 μm crossed irradiation fields, which was introduced through the biopsy channel of the endoscope. The light dose and the number of irradiation sessions were determined depending on the degree of damage to the oesophagus and stomach (from 4 to 7 sessions). The light dose of the session was up to 200 J. The power density of the laser radiation is 25 mW/cm2. Endoscopic photodynamic therapy can be used at the stage of combined treatment in combination with chemotherapy and surgery and is an effective means of preventing the failure of the oesophageal-small intestinal anastomosis in the early postoperative period. Due to photodynamic therapy in the preoperative period, the number of complications in the early postoperative period has significantly decreased. The leakage of the oesophageal-intestinal anastomosis developed in 4 cases, which make up 5.8%.