Photodynamic Therapy Controls Centrally Located Early Lung Cancers

Last Updated: 2009-08-25 17:32:15 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Photodynamic therapy (PDT) is effective as first-line therapy for patients with roentgenographically occult bronchogenic squamous cell carcinoma (ROSCC), according to a report in the August issue of Chest.

Photodynamic therapy is already a first-line treatment for centrally located early lung cancer in patients who are not surgical candidates, the authors explain.

Dr. Chiaki Endo from Tohoku University, Sendai, Japan, and colleagues investigated the long-term outcomes of 48 ROSCC patients treated with photodynamic therapy. In all cases, patients were medically operable, were free of metastasis, and had longitudinal tumor length of not more than 10 mm.

Forty-five patients (94%) achieved complete remission, the authors report, and all non-complete remission patients remained free of lung cancer at the last follow-up after undergoing additional treatment.

The local recurrence rate after complete remission was 20% (9/45 patients), with a relapse-free interval averaging 25 months in this group.

Ten patients had metachronous second primary lung cancers and 1 patient had a metachronous third primary lung cancer. The time from photodynamic therapy to metachronous primary lung cancer averaged 45 months.

At a median follow-up of 63 months, there were 11 deaths, with only 1 patient dying from the original ROSCC. This translates into overall survival rates of 81% at 5 years and 71% at 10 years.

Metachronous multiple primary lung cancer was an independent predictor of poor prognosis, the investigators say, but tumor location, local recurrence, and tumor response were not significant prognostic factors.

"The current study indicates that photodynamic therapy is thought to be a first-line modality for patients who have ROSCC with a tumor length of 10 mm or smaller, even if they are medically operable," the authors conclude.

They add, "Further study, especially a prospective study, should be conducted to get robust data of photodynamic therapy for medically operable patients with ROSCC."

Source:

Chest 2009;136:369-375.


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