1995 Volume 35 Issue 2 Pages 127-132
Eight patients with early stage lung cancer underwent photodynamic therapy (PDT) using a flexible bronchofiberscope from 1982 to 1993. All patients had one or two early epidermoid carcinomas in the central airway which were not detectable by chest radiography. Six patients, including two multiple primary cases had TisN0M0 lung cancers. Two patients had T1N0M0 lung cancers. Seven cancers in six patients were less than 10mm in length, while three cancers in two patients were greater than 10mm in length. Results of PDT were evaluated using biopsy specimens, sputum cytology and bronchofiberscopic observation at 2 and 4 weeks after the PDT. Five patients achieved complete response (CR). Three patients achieved partial response (PR). In the 8 cancers in the 6 patients with carcinomas in situ, 6 cancers in the 4 patients achieved CR. In the 7 cancers in the 6 patients which were less than 10mm in length, 5 cancers in 4 patients achieved CR.One CR case that had local recurrence and 2 PR patients received additional irradiation in the lung after the PDT and then achieved complete response. Median survival period was 50 + months (range 39-120 months). Three patients survived more than five years. Three patients died from secondary cancer, another 2 patients died from diseases unrelated to the malignancy. No patient died from primary lung cancer. These results suggest that PDT is effective in the treatment of inoperable patients with early bronchial carcinoma.Careful evaluation of the disease, with extensive biopsy specimens and additional irradiation of PR patients or recurrent patients seem to contribute to control of the disease.
