Abstract：
Given the highly heterogeneous characteristics of advanced gastric cancer (GC), most patients must receive neoadjuvant therapy or conversion therapy consisting of chemotherapy to decrease tumor grade and improve the likelihood of complete resection. Drug resistance, however, always leads to an aborted conversion therapy and inevitable death. When meet drug resistance, alternative drug regimens will be applied with immunotherapy or targeted therapy, whose clinical efficacy remains limited when new drug resistance or severer liver and kidney toxicity emerge. Photodynamic therapy (PDT), a novel treatment, has demonstrated remarkable therapeutic efficacy in different stages of GC. However, no report has been reported so far on the clinical application of photodynamic therapy in conversion therapy after drug resistance. Here we report a case of middle-aged patient with advanced GC, who experienced failure of conversion therapy consisted of multi-line chemotherapy along with immunotherapy. Ultimate success was achieved through a comprehensive conversion therapy of PDT, chemotherapy, immunotherapy, and targeted therapy. Subsequently, the patient underwent robotic-assisted radical gastrectomy while the surgical specimen showed no tumor cell exists. The patient underwent 3 cycles of systemic adjuvant therapy following surgical intervention. Presently, the patient remains 17 months in a satisfactory state of health.
摘要：
鉴于晚期胃癌（GC）的高度异质性特征，大多数患者必须接受新辅助治疗或包括化疗在内的转化治疗,以降低肿瘤分级并提高完全切除的可能性.耐药性,然而,总是导致转换治疗失败和不可避免的死亡。当遇到耐药性时，替代药物方案将应用免疫治疗或靶向治疗，当出现新的耐药性或严重的肝肾毒性时，其临床疗效仍然有限。光动力疗法(PDT),一种新颖的治疗方法，在GC的不同阶段表现出显著的治疗效果。然而,目前尚无关于光动力疗法在耐药后转化治疗中临床应用的报道。这里我们报道一例中年患者晚期GC,转换治疗失败的患者包括多线化疗和免疫治疗.最终的成功是通过综合的PDT转换治疗，化疗,免疫疗法，和靶向治疗。随后，患者接受了机器人辅助胃癌根治术,但手术标本显示无肿瘤细胞存在.患者在手术干预后接受了3个周期的全身辅助治疗。目前,患者仍处于令人满意的健康状况17个月。
