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Vol. 25, Art. 1 (pp. 1-15)    |    2024       

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Combined treatment of patients with locally advanced outlet obstructive gastric cancer: protocol of a pilot clinical trial

Svechkova A.A., Zakharenko A.A.

1Federal State Budgetary Educational Institution of Higher Education ?Academician I.P. Pavlov First St. Petersburg State Medical University? of the Ministry of Healthcare of Russian Federation, 197022, Russian Federation, St. Petersburg, st. Lev Tolstoy, 6-8

Brief summary

Gastric cancer is still a global health problem as a malignant neoplasm of high aggressiveness due to its heterogeneous nature. Despite the development of methods for early diagnosis and treatment, the overall 5-year survival rate for gastric cancer is 32.4%. Among patients admitted for treatment, 40% have a complicated course of the disease. In the structure of complications of gastric cancer, stenoses occur in 36.1% of cases, especially when the tumor is located in the cardioesophageal junction or in the outlet section of the stomach. Tumor obstruction of the stomach manifests itself already in the late stages of the disease and negatively affects the quality of life of patients due to the symptoms associated with it. Conducting a full-fledged neoadjuvant stage of treatment against the background of subcompensated gastric stenosis is often impossible due to increasing nutritional insufficiency, water and electrolyte disorders. Modern domestic and foreign clinical guidelines do not offer a unified standardized approach for gastric tumor obstruction in patients with a locally advanced process. Endoscopic photodynamic therapy seems to be a promising treatment method of potentially operable patients with malignant gastric outlet obstruction in combination with neoadjuvant chemotherapy. An objective assessment of the use of endoscopic photodynamic therapy in the combined treatment of locally advanced gastric cancer complicated by subcompensated tumor stenosis requires a clinical trial.


Key words

gastric cancer; endoscopic photodynamic therapy; malignant gastric outlet obstruction; combined treatment

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