Photodynamic Ablation of Early Cancers of the Stomach by Means of MTHPC and Laser Irradiation: Preliminary Clinical Experience

Overview

Journal Gut

Specialty Gastroenterology

Date 1998 Dec 24

PMID 9863479

Citations 13

Authors

C Ell

L Gossner

A May

H T Schneider

E G Hahn

M Stolte

R Sroka

Affiliations

Soon will be listed here.

Abstract

Background: Radical surgical treatment has been the first choice for early gastric cancer, but high resolution endosonography allows in situ diagnosis with a high sensitivity and specificity and in consequence the option of local endoscopic treatment.

Aims: To evaluate photodynamic therapy (PDT) using meso-tetrahydroxyphenyl-chlorin (mTHPC) as the photosensitiser in superficial gastric cancer.

Methods: Twenty two patients with superficial early gastric cancer received mTHPC (0.075 mg/kg intravenously) and were treated 96 hours later with red light at 652 nm (20 J/cm2). Tumour response was assessed by endoscopy and extensive biopsy.

Results: Endoscopies performed two to three days after PDT showed a haemorrhagic fibrinoid necrosis of the mucosal layer. Complete remission was achieved in 16/22 (73%) patients: 13/16 (80%) with intestinal type cancer and 3/6 (50%) with a diffuse Lauren's carcinoma. The mean follow up period was 12 months and 20 months, respectively. An average of 1.8 treatment sessions was required. Severe side effects were not observed. Seven patients had mild to moderate skin photo-sensivity reactions; 12 had local pain after PDT for 1-10 days.

Conclusion: PDT using mTHPC as the photosensitiser represents a safe and efficient method for topical treatment of early gastric cancer, especially of Lauren's intestinal carcinoma. If the preliminary results can be verified in larger patient series and during long term follow up, local treatment of early cancers of the stomach by PDT could be considered as a therapeutic option for selected patients.

Citing Articles

An Engineered Nanocomplex with Photodynamic and Photothermal Synergistic Properties for Cancer Treatment.

Varon E, Blumrosen G, Sinvani M, Haimov E, Polani S, Natan M Int J Mol Sci. 2022; 23(4).

PMID: 35216400 PMC: 8874418. DOI: 10.3390/ijms23042286.

Susceptibility and Resistance Mechanisms During Photodynamic Therapy of Melanoma.

Li X, Tan L, Dong L, Zhang W, Shen X, Lu X Front Oncol. 2020; 10:597.

PMID: 32528867 PMC: 7247862. DOI: 10.3389/fonc.2020.00597.

Engineering Multi-Walled Carbon Nanotube Therapeutic Bionanofluids to Selectively Target Papillary Thyroid Cancer Cells.

Dotan I, Roche P, Paliouras M, Mitmaker E, Trifiro M PLoS One. 2016; 11(2):e0149723.

PMID: 26901566 PMC: 4762941. DOI: 10.1371/journal.pone.0149723.

Photodynamic therapy with a novel porphyrin-based photosensitizer against human gastric cancer.

Chen J, Gao L, Liu T Oncol Lett. 2016; 11(1):775-781.

PMID: 26870283 PMC: 4727082. DOI: 10.3892/ol.2015.3953.

Photodynamic Treatment of Tumor with Bacteria Expressing KillerRed.

Yan L, Kanada M, Zhang J, Okazaki S, Terakawa S PLoS One. 2015; 10(7):e0131518.

PMID: 26213989 PMC: 4516238. DOI: 10.1371/journal.pone.0131518.

References

Weishaupt K, Gomer C, Dougherty T . Identification of singlet oxygen as the cytotoxic agent in photoinactivation of a murine tumor. Cancer Res. 1976; 36(7 PT 1):2326-9. View

Lee D, Lee S, Kwon S, Jang W, Shim Y, Cho M . Endoscopic mucosectomy using an esophageal variceal ligation device for minute gastric cancer. Endoscopy. 1996; 28(4):386-9. DOI: 10.1055/s-2007-1005486. View

Barr H, Bown S, Krasner N, Boulos P . Photodynamic therapy for colorectal disease. Int J Colorectal Dis. 1989; 4(1):15-9. DOI: 10.1007/BF01648544. View

Murata Y, Suzuki S, Ohta M, Mitsunaga A, Hayashi K, Yoshida K . Small ultrasonic probes for determination of the depth of superficial esophageal cancer. Gastrointest Endosc. 1996; 44(1):23-8. DOI: 10.1016/s0016-5107(96)70224-9. View

Yanai H, Tada M, Karita M, Okita K . Diagnostic utility of 20-megahertz linear endoscopic ultrasonography in early gastric cancer. Gastrointest Endosc. 1996; 44(1):29-33. DOI: 10.1016/s0016-5107(96)70225-0. View

Fockens P, Van den Brande J, Van Dullemen H, van Lanschot J, Tytgat G . Endosonographic T-staging of esophageal carcinoma: a learning curve. Gastrointest Endosc. 1996; 44(1):58-62. DOI: 10.1016/s0016-5107(96)70230-4. View

Kajiyama T, HAJIRO K, Sakai M, Inoue K, Konishi Y, Takakuwa H . Endoscopic resection of gastrointestinal submucosal lesions: a comparison between strip biopsy and aspiration lumpectomy. Gastrointest Endosc. 1996; 44(4):404-10. DOI: 10.1016/s0016-5107(96)70089-5. View

Braichotte D, Savary J, Monnier P, van den Bergh H . Optimizing light dosimetry in photodynamic therapy of early stage carcinomas of the esophagus using fluorescence spectroscopy. Lasers Surg Med. 1996; 19(3):340-6. DOI: 10.1002/(SICI)1096-9101(1996)19:3<340::AID-LSM10>3.0.CO;2-8. View

Natsugoe S, Yoshinaka H, Moringa T, Shimada M, Hokita S, Baba M . Assessment of tumor invasion of the distal esophagus in carcinoma of the cardia using endoscopic ultrasonography. Endoscopy. 1996; 28(9):750-5. DOI: 10.1055/s-2007-1005599. View

10.

Takeshita K, Tani M, Inoue H, Saeki I, Hayashi S, Honda T . Endoscopic treatment of early oesophageal or gastric cancer. Gut. 1997; 40(1):123-7. PMC: 1027021. DOI: 10.1136/gut.40.1.123. View

11.

Ris H, Altermatt H, Inderbitzi R, Hess R, NACHBUR B, Stewart J . Photodynamic therapy with chlorins for diffuse malignant mesothelioma: initial clinical results. Br J Cancer. 1991; 64(6):1116-20. PMC: 1977841. DOI: 10.1038/bjc.1991.474. View

12.

Bedwell J, MacRobert A, Phillips D, Bown S . Fluorescence distribution and photodynamic effect of ALA-induced PP IX in the DMH rat colonic tumour model. Br J Cancer. 1992; 65(6):818-24. PMC: 1977757. DOI: 10.1038/bjc.1992.175. View

13.

Inoue H, Takeshita K, Hori H, Muraoka Y, Yoneshima H, Endo M . Endoscopic mucosal resection with a cap-fitted panendoscope for esophagus, stomach, and colon mucosal lesions. Gastrointest Endosc. 1993; 39(1):58-62. DOI: 10.1016/s0016-5107(93)70012-7. View

14.

Loh C, MacRobert A, Bedwell J, Regula J, Krasner N, Bown S . Oral versus intravenous administration of 5-aminolaevulinic acid for photodynamic therapy. Br J Cancer. 1993; 68(1):41-51. PMC: 1968297. DOI: 10.1038/bjc.1993.284. View

15.

Tada M, Murakami A, Karita M, Yanai H, Okita K . Endoscopic resection of early gastric cancer. Endoscopy. 1993; 25(7):445-50. DOI: 10.1055/s-2007-1010365. View

16.

Yasuda K, Mizuma Y, Nakajima M, Kawai K . Endoscopic laser treatment for early gastric cancer. Endoscopy. 1993; 25(7):451-4. DOI: 10.1055/s-2007-1010366. View

17.

Endo M . Endoscopic resection as local treatment of mucosal cancer of the esophagus. Endoscopy. 1993; 25(9):672-4. DOI: 10.1055/s-2007-1010430. View

18.

Ell C, Gossner L . Photodynamic therapy: its potential for the treatment of gastrointestinal malignancies and precancerous conditions. Endoscopy. 1994; 26(2):262-4. DOI: 10.1055/s-2007-1008958. View

19.

Jin M, Yang B, Zhang W, Wang Y . Photodynamic therapy for upper gastrointestinal tumours over the past 10 years. Semin Surg Oncol. 1994; 10(2):111-3. DOI: 10.1002/ssu.2980100209. View

20.

Takekoshi T, Baba Y, Ota H, Kato Y, Yanagisawa A, Takagi K . Endoscopic resection of early gastric carcinoma: results of a retrospective analysis of 308 cases. Endoscopy. 1994; 26(4):352-8. DOI: 10.1055/s-2007-1008990. View