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 management for superficial carcinomas of the oesophagus and gastric cardia. Thirty-one patients with superficial oesophageal or gastric cardiac carcinomas, who refused or were unsuitable for surgery, received endoscopic Nd:YAG laser therapy combined with local injection of chemotherapeutic drugs 5-fluorouracil and mitomycin. After one to four sessions of treatment no cancer cells were detected by multiple biopsies and no complications such as bleeding or perforation occurred in any case. The 31 patients have been followed-up for 25-91 months (five cases for 91 months, eight cases for 79 months, four cases for 55 months, eight cases for 33 months and six cases for 25-31 months). All patients are surviving without sign of recurrence and no cancer cells were detected by endoscopic biopsies. Our findings indicate that this is an effective and safe therapeutic modality and may be considered as the first choice for those patients who refuse or are not suitable for surgery, and for those of older age and in poor condition.