- 著者
-
楢原 啓之
三村 征四郎
- 出版者
- 特定非営利活動法人 日本レーザー医学会
- 雑誌
- 日本レーザー医学会誌 (ISSN:02886200)
- 巻号頁・発行日
- vol.16, pp.39-42, 1995
Esophageal cancer reacts to photodynamic therapy (PDT) markedly and it necrotizes easily besides the ulcer after PDT repairs soon, because it is more sensitive to PDT than gastric cancer. In order to improve the therapeutic effectiveness of PDT with Photofrin II and laser light for superficial esophageal cancer, we employed an excimer dye laser instead of an argon dye laser since 1990. The characteristics of the current laser are as follows: wavelength, 630nm; pulse energy, 4mJ; peak power, 400kW; pulse width, 10nsec; frequency of repetition, 80Hz; average output, 320mW. The entire lesion plus a 5-mm wide perimeter of mucosa was irradiated with an EDL beam at 630nm wave length transmitted endoscopically.<BR>In PDT for esophageal cancer, we had used a front-view fiberscope (model GIF-P10, GIF-XQ20, Olympus, Tokyo, Japan) for five cases with esophageal cancer according to the traditional method of diagnostic endoscopy until 1991. But uniform irradiation was difficult, especially with large lesions, because of esophageal peristalsis and respiratory movement. Since the first trial using a side-view fiberscope in PDT for esophageal cancer in 1992, we used a side-view fiberscope (model GF-20, Olympus, Tokyo, Japan) for five cases with esophageal cancer, not only in PDT, but also in pretreatment examinations and follow-up examinations. Two of them were located in abdominal esophagus (Ea) just above EC junction, where PDT had been considered out of application. In this procedure, patients with a lesion located on the right side can lie in a left lateral position as usual, whereas patients with a lesion located in the left side, especially from 7 to 10 o'clock, must lie in a right lateral position. This enabled photoradiation of esophageal cancer from a 90°angle without any difficulty, besides with less energy intensity of the irradiated laser light. Of these 10 lesions, 9 were cured by initial treatment and no recurrence was proved by endoscopy and biopsy. The final rate of cure was 90% (9/10).