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The journal «ONCOSURGERY» 2012, Vol.4, No 3

Intraoperative photodynamic therapy for locally advanced and disseminated gastric cancer

Filonenko ЕV, Vashakmadze LА, Kirillov NV, Khomyakov VМ, Kolobaev IV, Krylova GI

PA. Herzen Moscow Cancer Research Institute, Moscow, Russia
Contact: Kirillov NV, e-mail:

The method of intraoperative photodynamic treatment of peritoneum (IOPDT) for surgical treatment of locally advanced and disseminated gastric cancer was developed.

IOPDT was performed in 84 patients who underwent relatively radical and palliative surgery. The selection of patients based on pre-operative examination data. IOPDT was planed for evidence of tumor invasion of all layers of stomach wall, invasion to adjacent structures or indirect sighns of peritoneal involvement, ovarian metastases. 48 h before surgery patient received forogem in dose 2,5 mg/kg intravenously. All patients underwent subtotal distal gastric resection or gastrectomy with D2, D3 lymphadenectomy. The session of irradiation of peritoneum was performed after surgical step. Laser system LFT-630-01 «Биоспек» (the wavelength 630 nm), light dose of 6 J/cm2, total energy up to 1680 J was used. The follow-up period was 6 to 72 months. The efficacy of IOPDT was assessed by comparing of corrected survival rates in study and control groups using the Kaplan-Meier method. The rate, structure and severity of complications for this method in study and control groups were equal. In the study group for relatively radical surgery 1-year survival rates were 92±4.2%, 3-year – 67.7±8.2%. In the control group with median of 26.9 months 1-year survival rates were 81±5%, 3-year 38.5±6.9%. The median survival rate was 40 months in the study group and 26, in the control group. The differences between groups were statistically significant (p=0.042 log rank).

Thus, IOPDT did not increase the rate of complications and did not change its structure, slightly extended the duration of surgery and may be used for improvement of surgical ablastics in patients with locally advanced gastric cancer.

KEY WORDS: intraoperative photodynamic therapy, gastric cancer.

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