INTRAOPERATIVE PHOTODYNAMIC THERAPY IN GASTRIC CANCER PATIENTS

Results of intraoperative photodynamic therapy (IOPDT) in patients with gastric cancer are represented in the article. The study included 240 patients with gastric cancer stage II-IV (Т3-4N0-3M0-1) with  evident or suspected peritoneal dissemination who underwent  examination and treatment in P.Herzen Moscow Oncology Research  Institute. The group 1, the study group, included 140 patients who  underwent nominally curative or palliative surgery for locally  advanced and disseminated gastric cancer with IOPDT as additional  intraoperative intervention for antiblastics and cancer treatment. The group 2, the control group, included 100 patients who also  underwent nominally curative or palliative surgery (equal to extent  of surgery in patients from the study group) for locally advanced and disseminated gastric cancer and no intraoperative implication of physical or chemical treatment methods. IOPDT did not worsen a course of early post-operative period, did not impact on severity of  post-operative complications and was not associated with increase of post-operative mortality. IOPDT allowed for improvement of 1-year  and 3-year disease-specifi c survival rates: by 16.1% and 16.7%,  respectively. For nominally curative resections, median survival, 1- year and 3-year disease-specifi c survival rates were improved by 14 months, 17.8% and 31.3%, respectively. For R1, R2 resections,  IOPDT improved 1-year disease-specifi c survival rates by 16.4%. Additionally, for nominally curative resections IOPDT did not increase the recurrence rate and improved median recurrence-free survival,  1-year and 3-year recurrence-free survival rates by 16 months,  27.2% and 25.4%, respectively. 

1. Zlokachestvennye novoobrazovaniya v Rossii v 2015 godu (zabolevaemost' i smertnost') [Malignant neoplasms in Russia in 2015 (incidence and mortality)], by eds Kaprin A.D., Starinskii V.V., Petrova G.V. Moscow, MNIOI im. P.A. Gertsena Publ., 2017. 250 p.

2. Filonenko Е.V. Vashakmadze L.А. Kirillov N.V. Khomyakov V.М. Intraoperative photodynamic therapy in surgical treatment of gastric cancer (literature review), Sibirskii onkologicheskii zhurnal, 2012, No. 2, pp. 84-89. (in Russian)

3. Sugarbaker P.H., Cunliffe W.J., Belliveau J., de Bruijn E.A., Graves T., Mullins R.E., Schlag P. Rationale for integrating early postoperative intraperitoneal chemotherapy into the surgical treatment of gastrointestinal cancer, Semin Oncol, 1989, Vol. 16(4 Suppl 6), pp. 83-97.

4. Bando E., Yonemura Y., Takeshita Y., Taniguchi K., Yasui T., Yoshimitsu Y., Fushida S., Fujimura T., Nishimura G., Miwa K. Intraoperative lavage for cytological examination in 1,297 patients with gastric carcinoma, Am J Surg, 1999, Vol. 178(3), pp. 256-262.

5. Solomenny S.V., Minigazimov R.S. Peritoneal carcinomatosis. review of world experience, Kreativnaya khirurgiya i onkologiya, 2013, No. 4, pp. 115-119. (in Russian)

6. Guse’nov A.Z., Istomin D.A., Guseinov T.A. Volume of operative interventions at the gastric cancer: modern tendencities, Vestnik novykh meditsinskikh tekhnologii. Elektronnoe izdanie, 2013, No. 1, p. 165. (In Russian)

7. Zagainov A.S., Zubkov R.A., Dvornichenko V.V., Golodnikov M.A., Gorbanyova O.A The immediate benefits of extended lymph node dissection for advanced gastric cancer, Sibirskii Medicinskii Zhurnal. 2014, Vol. 131, No. 8, pp. 64-67. (in Russian)

8. Ter-Ovanesov M.D., Levickij A.V., Gaboyan A.S., Kukosh M.Yu., Lesnidzeh E.H., Baksiyan G.A. Proximal third gastric carcinoma: extent of surgical resection as prognostic factor, Al'manah mirovoi nauki, 2015, No. 1-1(1), pp. 68-70. (in Russian)

9. Chernyavskij A.A., Lavrov N.A., Strazhnov A.V., Penin S.V. Resections on pancreas during surgeries for gastric cancer, Vestnik khirurgicheskoi gastroenterologii, 2013, No. 3, pp. 4-13. (in Russian)

10. Bijelic L., Yan T.D., Sugarbaker P.H. Failure analysis of recurrent disease following complete cytoreduction and perioperative intraperitoneal chemotherapy in patients with peritoneal carcinomatosis from colorectal cancer, Ann. Surg. Oncol., 2007, Vol. 14, pp. 2281–2288.

11. Japanese Gastric Cancer Association Gastric. Japanese Classification of Gastric Carcinoma - 2nd English Edition, Cancer, 1998, Vol. 1, pp. 10-24.

12. Rajeshkumar B.R., Paliwal S., Lambert L., Grossman S.R., Whalen G.F. Treatment of peritoneal carcinomatosis with intraperitoneal administration of Ad-hARF, J Surg Res, 2015, Vol. 197(1), pp. 85-90.

13. Chua T.C., Moran B.J., Sugarbaker P.H., Levine E.A., Glehen O., Gilly F.N., Baratti D., Deraco M., Elias D., Sardi A., Liauw W., Yan T.D., Barrios P., Gómez Portilla A., de Hingh I.H., Ceelen W.P., Pelz J.O., Piso P., González-Moreno S., Van Der Speeten K., Morris D.L. Early- and longterm outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, J Clin Oncol, 2012, Vol. 30, pp. 2449-2456.

14. Glehen O., Kwiatkowski F., Sugarbaker P.H., Elias D., Levine E.A., De Simone M., Barone R., Yonemura Y., Cavaliere F., Quenet F., Gutman M., Tentes A.A., Lorimier G., Bernard J.L., Bereder J.M., Porcheron J., Gomez-Portilla A., Shen P., Deraco M., Rat P. Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study, J Clin Oncol, 2004, Vol. 22, pp. 3284-3292.

15. Nadiradze G., Giger-Pabst U., Zieren J., Strumberg D., Solass W., Reymond M.A. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with low-dose cisplatin and doxorubicin in gastric peritoneal metastasis, J. Gastrointest. Surg., 2016, Vol. 20, pp. 367-373.

16. Tarasov V.A., Vinogradova M.V., Klyuchikov V.Z., Belyaev A.M. Surgical treatment for advanced gastric cancer, Prakticheskaya onkologiya, 2001, Vol. 3(7), pp. 52-58. (In Russian)

17. Kaprin A.D., Sobolev D.D., Khomyakov V.M., Bolotina L.V., Ryabov A.B., Khoronenko V.E. Kolobaev I.V., Shemetova M.M., Kramskaya L.V., Ivanov A.V. Results of combined treatment using hyperthermic intraoperative intraperitoneal chemotherapy in patients with locally advanced and disseminated gastric cancer, Onkologiya. Zhurnal imeni P.A. Gertsena, 2014, Vol. 2, No. 6, pp. 5-12. (in Russian)