Abstract
Purpose
The role of photodynamic therapy (PDT) in the treatment of small cancers has been established in several clinical studies. Here, we report on the efficacy of PDT for early inoperable or recurrent nonβsmallβcell lung cancer (NSCLC).
Methods and Materials
From June 1989 to November 2004, 40 patients with 50 NSCLC were treated with PDT. Twelve cases were inoperable for medical reasons and were staged as T1N0M0, and 28 had recurrent in situ carcinoma. Patients with residual disease after PDT received definitive radiotherapy and/or brachytherapy. Followβup ranged from 6 to 167 months (median 43.59). Twenty of the 40 patients received i.v. injections of hematoporphyrin derivative (5 mg/kg), the other 20 had injections of porfimer sodium (Photofrin, 2 mg/kg). An argon dye laser (630 nm wavelength, 200β300 J/cm^2^) was used for light irradiation in 24 of the 40 patients, a diode laser (Diomed, 630 nm wavelength, 100β200 J/cm^2^) in the other 16.
Results
PDT obtained a 72% complete response (CR) rate (36/50 treated lesions), that is 27 CR among the 37 Tis carcinomas and 9 among the 13 T1 cases. KaplanβMeier curves showed a mean overall survival (OS) of 75.59 months (median 91.4 months). Twoβ and 5βyear OS rates were 72.78% and 59.55%. The mean and median survival rates for patients with Tis stage were 86.5 and 120.4 months, respectively (standard error 9.50) and for patients with T1 disease they were 45.78 and 35.71 months, respectively; the difference was statistically significant (Pβ=β0.03). No severe early or late PDTβrelated adverse events were recorded.
Conclusions
PDT is effective in early primary or recurrent NSCLC, resulting in a CR rate of 72%. The incorporation of PDT in standard clinical practice, in combination with radiotherapy, warrants further investigation. Lasers Surg. Med. 39:394β402, 2007. Β© 2007 WileyβLiss, Inc.