We have reported that PhotoDynamicTherapy (PDT) on inoperable gastric cancer and unable case for endoscopic mucosal resection (EMR) . On this report, we handle such case for using PDT and Nd-YAG Laser.
A 69-year-old woman, had Type IIc gastric cancer with poorly differentiated adenocarcinoma cells. She had also trouble with severe respiratory dysfunction that impossible to recieved routine upper gastric endoscopy examination. Endoscopic ultrasonography examination implied invasion of submucosal layer. We decided to make gastric fistula, so that she could endure long term endoscopic procedure.
We made fistula in middle body of anterior wall by using endoscopy. Fifty hours after intravenous injection of PHE (Porfimer sodium) , we performed Excimer Dye Laser (EDL-1) . One week after PDT, histological biopsy specimen showed residual cancer cells. We performed Nd-YAG Laser as additional therapy on that lesion. After 4 months of laser therapy, histological biopsy specimen was not revealed carcinoma cells. It was considered that inoperable case, or unsuitable case for EMR, endoscopic laser therapy will show the efficacy for local cure.
