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Endoscopy 2000; 32(8): 609-613
DOI: 10.1055/s-2000-9013
Original Article
Georg Thieme Verlag Stuttgart · New York

Shape-Memory Alloy Loop Snare for Endoscopic Photodynamic Therapy of Early Gastric Cancer

T. Nakamura 1 , H. Fukui 2 , Y. Ishii 3 , M. Fujita 4 , K. Hori 5 , K. Ejiri 3 , M. Ejiri3 , T. Fujimori 4
  • 1 Dept. of Clinical Pathology and Laboratory Medicine, Kobe National Hospital, Kobe, Japan
  • 2 Dept. of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
  • 3 Jyoyo-Ejiri Hospital, Himeji, Japan
  • 4 Dept. of Pathology, Dokkyo University School of Medicine, Tochigi, Japan
  • 5 Hori Clinic, Kakogawa, Japan
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Publikationsdatum:
31. Dezember 2000 (online)

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Background and Study Aims: Photodynamic therapy (PDT) has proved effective in the treatment of gastric cancer, but there is room for improvement. To achieve the technical goal of carrying out endoscopic PDT, endoscopists need to determine the precise area for laser irradiation at adequate dosages. This report describes the use of a shapememory alloy (SMA) loop snare as a useful tool in endoscopic PDT.

Patients and Methods: Eleven patients with biopsyproved early gastric cancer were treated with endoscopic PDT after intravenous injection of Photofrin II (2 mg/kg b.w.). Five patients underwent PDT using the SMA loop snare, and six underwent PDT without the use of the device. Cancer lesions smaller than 2 cm in diameter were irradiated with an excimer-dye laser (4 mJ, 80 Hz, 630 nm) for 20 min.

Results: All five patients (100 %) treated with PDT using the SMA loop snare, and four of the six patients (67 %) treated with PDT without use of the SMA loop snare, showed complete remission.

Conclusions: The SMA loop snare routinely forms a circle 2 cm in diameter, covering an area of 3.14 cm2, and makes it possible to mark and calculate the precise area of cancerous lesions for irradiation at appropriate dosages. The findings of this study suggest that the SMA loop snare is an effective tool for PDT in early gastric cancer.

References

  • 1 Gregorie HB, Horger EO, Ward JL, et al. Hematoporphyrin-derivative fluorescence in malignant neoplasms.  Ann Surg. 1968;  167 820-828
    PubMedGoogle Scholar
  • 2 Weishaup KR, Gomer CJ, Dougherty TJ. Identification of singlet oxygen as the cytotoxic agent in photoinactivation of a murine tumor.  Cancer Res. 1976;  36 2326-2329
    PubMedGoogle Scholar
  • 3 Gomer CJ, Dougherty TJ. Determination of [3H]- and [14C]hematoporphyrin derivative distribution in malignant and normal tissue.  Cancer Res. 1979;  39 146-151
    PubMedGoogle Scholar
  • 4 Ell C, Grossner L, May A, et al. Photodynamic therapy of early gastric cancer with mTHPC.  Gut. 1998;  43 345-349
    PubMedGoogle Scholar
  • 5 Grossner L, Sroka, R, Hahn EG, Ell C. Photodynamic therapy: successful destruction of gastrointestinal cancer after oral administration of aminolevulinic acid.  Gastrointest Endosc. 1995;  41 55-58
    PubMedGoogle Scholar
  • 6 Fujimori T, Nakamura T, Yoshida S, et al. Endoscopic mucosectomy for early gastric cancer using modified strip biopsy.  Endoscopy. 1992;  24 187-189
    PubMedGoogle Scholar
  • 7 Mimura S, Ito Y, Hayata Y, et al. Cooperative clinical trial of photodynamic therapy with Photofrin II and excimer dye laser for early gastric cancer.  Lasers Surg Med. 1996;  19 168-172
    CrossrefPubMedGoogle Scholar
  • 8 Dellinger M, Vever-Bizet C, Brault D, et al. Uptake and photodynamic efficiency of hematoporphyrin, hydroxyethylvinyldeuteroporphyrin and hematoporphyrin derivative (Photofrin II): a study with isolated mitochondria.  Photochem Photobiol. 1990;  51 185-189
    PubMedGoogle Scholar
  • 9 Tsuchida T, Zheng G, Pandey RK, et al. Correlation between site II-specific human serum albumin (HSA) binding affinity and murine in vivo photosensitizing efficacy of some Photofrin components.  Photochem Photobiol. 1997;  66 224-228
    PubMedGoogle Scholar
  • 10 Schomacker KT, Walsh A, Gregory KW, Kochevar IE. Cell damage induced by Angiovist-370 and 308 nm excimer laser radiation.  Lasers Surg Med. 1997;  20 111-118
    CrossrefPubMedGoogle Scholar
  • 11 Kochevar IE, Walsh AA, Green HA, et al. DNA damage induced by 193-nm radiation in mammalian cells.  Cancer Res. 1991;  51 288-293
    PubMedGoogle Scholar
  • 12 Mimura S, Ichii M, Imanishi K, et al. Evaluation of photodynamic therapy for gastric cancer.  Dig Endosc. 1990;  2 265-274
    PubMedGoogle Scholar
  • 13 Sibille A, Descamps C, Jonard P, et al. Endoscopic Nd:YAG treatment of superficial gastric carcinoma: experience in 18 Western inoperable patients.  Gastrointest Endosc. 1995;  42 340-345
    PubMedGoogle Scholar

M.D. T. Fujimori

Dept. of Pathology Dokkyo University School of Medicine

880, Kitakobayashi, Mibu, Shimotsuga

Tochigi 321-0293

Japan

Telefon: +81-282-86-1681

eMail: t-fuji@dokkyomed.ac.jp

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