Komei Kinoshita

Evaluation of photodynamic therapy in gastric cancer

Twenty-eight patients with gastric cancer were treated by photodynamic therapy. Haematoporphyrin derivative was used as a photosensitizer and an argon dye laser as a light source. Histologically, all tumours were adenocarcinomas. On the basis of endoscopy, 17 cases were categorized as early-stage cancer and were classified as type IIc (10 lesions), Ha (three lesions), combined type IIc and type III (three lesions) and type I (two lesions). In 11 patients with advanced-stage cancer, endoscopy showed one case of Borrmann I, three of Borrmann II, six of Borrmann III and a single case of Borrmann IV. In the 17 patients with early-stage cancers (18 lesions), complete remission was obtained in 10 patients (11 lesions). Of 13 resected cancers complete remission was confirmed in six lesions on the basis of detailed histological examination of resected specimens. In the advanced stage tumours all 11 patients showed incomplete remissions. It is considered that an incomplete response in the early-stage cancers is due to insufficient light dosage because of the wide area of tumour, because the site of the lesion is anatomically difficult to photoradiate and because the invasion extends to the muscular layer and serosa.

Effectiveness of HPD and Radiation Therapy in Lung Cancer

The diagnostic rate of lung cancer has been improved by the development of the fiberoptic bronchoscope and this instrument has particularly promoted the detection of early stage of central type lung cancer. But therapeutic results have been unsatisfactory, partly because of difficulties in resecting cases with poor pulmonary function. On the other hand, chemotherapy and radiation therapy can have serious side effects. New therapeutic modalities are therefore required for treatment of early stage inoperable lung cancer cases.

Photodynamic therapy with Photofrin II by bronchial artery infusion

Photodynamic therapy (PDT) utilizing Photofrin II is proving to be an effective modality in the treatment of early stage lung cancer. However, wider clinical application of Photofrin II as a photosensitizer for various cancers is hampered by the potentially serious and prolonged skin photosensitivity. To prevent these side effects and reduce the inpatient period, we recently tried to give reduced doses of Photofrin II by bronchial artery infusion (BAI). Six patients with endoscopically evaluated early stage carcinoma of the lung were given 0.7 mg/kg of Photofrin II by BAI 48 hours before PDT. Complete remission was obtained in all 6 cases, and there was no evidence of skin photosensitivity when exposed to outside light under careful surveillance at one week after PDT.