Thérapie photodynamique dans le cancer gastrique
Photodynamic therapy in gastric cancer
PDT (photodynamic therapy) is a promising treatment for neoplasm in the gastrointestinal tract including gastric cancer. Clinical trial of PDT (combination of hematoporphyrin derivative and an argon dye laser) for early gastric cancer started in 1979. PDT using porfimer sodium (PHE, freeze-dried Photofrin II) and a pulsed excimer dye laser (EDL) was approved by government of Japan in 1996. Early gastric cancer is indicated for PDT only in Japan. Endoscopic mucosal resection (EMR) is considered the first choice treatment in early gastric cancer but its indication is limited to intramucosal carcinoma. Moreover, sometimes serious complications such as perforation occur. On the other hand, PDT has no serious complications and contributes to patient’s quality of life. Development of new photosensitizers and more effective lasers, and improvement of technique in PDT will enable more effective treatment for not only early stage but also advanced gastric cancers.
T. NAKAMURA, K. SHIRAKAWA, T. FUJIMORI, A. TERANO
advanced gastric cancer, early gastric cancer, endoscopic mucosal resection (EMR), photodynamic therapy (PDT)