Current role of laser and photodynamic therapy in gastrointestinal tumors and analysis of a 10-year experience.
Laser energy can be used for a variety of neoplastic diseases including benign tumors, early stage malignancies, and advanced carcinomas, either with curative intent or for palliation. Nd:YAG laser photocoagulation of 168 colorectal adenomas allowed a complete eradication in 70% of cases, after a mean follow-up of 22 months. Advanced and obstructing tumors were treated with Nd:YAG laser to recanalize the lumen. In the upper gastrointestinal tract the recanalization of the lumen by means of laser photocoagulation improved the quality of life and survival. In fact, in our series of 308 patients treated, 1-year survival was 23% in recanalized patients and 7% in nonrecanalized patients. In the lower gastrointestinal tract, 289 cancer patients were treated and an amelioration of symptoms related to the obstruction was obtained in 93%. The current indication for photodynamic therapy is mainly the treatment of flat or ulcerative early stage tumors in the esophagus and stomach of high risk patients. Out of 17 patients treated, 14 were locally cured.
Spinelli
P
P
Endoscopy Division, Istituto Nazionale Tumori, Milan, Italy.
Dal Fante
M
M
Mancini
A
A
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000601:surgery; D017323:Dihematoporphyrin Ether; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D006414:Hematoporphyrin Photoradiation; D006415:Hematoporphyrins / Q000627:therapeutic use; D006801:Humans; D008028:Light Coagulation; D008297:Male; D010166:Palliative Care
D000970:Antineoplastic Agents; D006415:Hematoporphyrins; D017323:Dihematoporphyrin Ether