Photothermal Adjunctive Cytoreductive Surgery for Treating Peritoneal Metastasis of Gastric Cancer

Although the combination therapy of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy has improved survival rates in selected patients with peritoneal metastasis (PM), therapeutic efficiency remains a challenge due to low targeting specificity, poor tissue penetration of chemotherapy drugs, and incomplete tumor clearance. To overcome these drawbacks, novel gold nanoshells conjugated with indocyanine green (I-GSNs) for image-guided photothermal adjunctive CRS (iPTA-CRS) are synthesized. The as-prepared nanoparticles effectively accumulate both in subcutaneously transplanted and PM models. I-GSN-mediated near-infrared imaging provides sufficient optical contrast for preoperative guidance and intraoperative resection with the accurate detection of visible/microtumor lesions (<3 mm). The strategy is significantly more effective for removing subcutaneously transplanted tumors, inhibiting PM nodules of the gastric tumor, and enhancing the survival rate (≈33%) than other treatments (0%) in the 60 d observation period. This novel iPTA-CRS may benefit future clinical translations for gastric cancer patients with PM.