Among 43 cases of lung cancer treated by endoscopic laser therapy since 1987, we analyzed the effect of endoscopic photodynamic therapy (PDT) on 4 cases of inoperable Stage 1 hilar lung cancer. PDT was performed by laser irradiation using the gold vaper laser or excimer dye laser after hematoporphyrin (HPD) infusion.
All of these 4 cases had hemoptysis at the first medical examination, and diagnosed as a hilar lung cancer with a clinical classification of stage 1. PDT was selected and performed for these 4 cases, as an operation could not be undergone because of the patients age, poor respiratory function, or patient's refusal.
More than 4 weeks after PDT, bronchoscopy and TBLB were performed with a finding of no cancer cells remaining and complete response of PDT for hilar lung cancer was confirmed. Two of 4 cases demonstrated marked improvement of obstructive pneumonia caused by bronchial stenosis in a hilar lesion.
Prognosis of these 4 cases was excellent. One case died of interstitial pneumonia after 11 months of PDT. Although two cases had a recurrence of hilar cancer months or 1 year and 2 months after PDT, combined therapy of radiation, chemotherapy, and PDT were performed and they survived for 2 years and 6 months and 4 years and 10 months. The other case has no symptom of recurrence after 1 year of PDT.
(Summary) Endoscopic photodynamic therapy appears to be effective for the treatment of hilar lung cancer, and especially improves quality of life and survival of the patient who has no indication for an operation because of aging or poor respiratory function.
