Objective Laparoscopy-assisted distal gsstrectomy (LADG) with D1 + β lymph node dissection has become the most popular treatment for early gastric cancer in Asian countries. However, no one has shown the same clinical advantages with this procedure as with LADG with D1 + α lymph node dissection. The aim of this study was to compare the outcome of LADG with D1 + β to that of LADG with D1 + α lymph node dissection. Methods During the period of June 2002 through June 2006, LADG with D1 + α lymph node dissection was performed in 54 patients, and LADG with D1 + β lymph node dissection was performed in 42 patients. Surgical findings, clinicopathologic data, postoperative course, complications, and blood analysis findings were compared between the two groups. Differences were analyzed with Mann-Whitney U test and chi-square test. Results Patients in the two groups were comparable with respect to age, sex, body mass index, and stage and pathologic characteristics of gastric cancer. A significantly greater number of N2 lymph nodes were harvested by D1 + β lymph node dissection than by D1 + α dissection (5.9vs. 2.7, P<0.01). However, no significanees in the total number of retrieved lymph nodes (24.7 vs. 22.2) or perigastric lymph nodes dissected (18.9 vs. 19.4) were identified between the D1 + β and D1 +α groups. There was also no significant difference between the D1 + α and D1 + β groups with respect to operation time, blood loss, complication rate, time to first walking, first flatus, first eating, and first defecation, frequency of analgesics, volume of oral intake on postoperative day 7, weight loss, and postoperative hospital stay. Blood analysis showed there were no significant differences in white blood cell count, levels of C-reactive protein, and serum albumin. Conclusion The short-term outcome of LADG with D1 + β lymph node dissection is comparable to that of LADG with D1 + α lymph node dissection.

A case report
A 70-year-old male with small bowel adenocarcinoma involving retroperitoneal invasion had undergone chemotherapy after non-curative operation. However, this patient had to discontinue the first and second lines of chemotherapies within one month due to serious side effects of anti-cancer agents. Subsequently, the patient complained of severe low-back pain and there was evidence of local recurrence around the resected small intestine. Therefore, phototherapy was applied three times a week to relieve the low-back pain while the patient underwent the third line of chemotherapy. It was interesting to note that these combination therapies coincidentally ameliorated the various side effects caused by anti-cancer drugs. For one year during the third line of chemotherapy, the patient had to temporarily discontinue chemotherapy only two times when phototherapy was not available for one week due to consecutive national holidays in May and November. The quality of life of this patient was well maintained, and he only needed to be hospitalized for the last two months before he died.
Epidemiological studies have shown a high incidence of cancer in people less exposed to solar rays. The sunshine “vitamin” 1 alpha, 25-dihydroxy vitamin D₃ (1, 25(OH)₂D₃) is involved in these epidemiological studies based on the evidence that 1, 25(OH)₂D₃ is an antiproliferative agent that may inhibit proliferation of cancer cells in vitro and development in animals. To elucidate the synergetic effect of phototherapy in combination with chemotherapy, we assayed serum levels of 1, 25(OH)₂D₃ in this patient compared with those of end-stage cancer patients undergoing chemotherapy alone. Serum levels of 1, 25(OH)₂D₃ in this patient after receiving the combination therapies were higher than those in other cancer patients treated with chemotherapy alone.
Our results indicate that phototherapy may be a good complementary therapy with chemotherapy for cancer patients.