Endoscopic Nd : YAG laser therapy combined with local chemotherapy of superficial carcinomas of the oesophagus and gastric cardia

The aim of this study was to explore the possibilities of non-surgical mana gement for superficial carcinomas of the oesophagus and gastric cardia. Thi rty-one patients with superficial oesophageal or gastric cardiac carcinomas , who refused or were unsuitable for surgery, received endoscopic Nd:YAG la ser therapy combined with local injection of chemotherapeutic drugs 5-fluor ouracil and mitomycin. After one to four sessions of treatment no cancer ce lls were detected by multiple biopsies and no complications such as bleedin g or perforation occurred in any case. The 31 patients have been followed-u p for 25-91 months (five cases for 91 months, eight cases for 79 months, fo ur cases for 55 months, eight cases for 33 months and six cases for 25-31 m onths). All patients are surviving without sign of recurrence and no cancer cells were detected by endoscopic biopsies. Our findings indicate that thi s is an effective and safe therapeutic modality and may be considered as th e first choice for those patients who refuse or are not suitable for surger y, and for those of older age and in poor condition.