Abstract
Since 1980, advanced lung carcinomas were treated with palliative laser therapy for the purpose of opening the endobronchial stenosis and obstruction by either photodynamic therapy (PDT) or Nd-YAG laser treatment at Tokyo Medical University. A total of 258 lesions were treated, 81 by PDT and 177 by Nd-YAG laser treatment. PDT achieved effective results in 61 (75%) of 81 lesions. In the Nd-YAG laser group, 143 (81%) of 177 lesions showed effective results. When the tumor was located in the trachea or main bronchi, effective results were obtained in 73% (19 of 26) of cases treated by PDT and in 93% of cases (64 of 69) treated by Nd-YAG laser. However, in cases in which the tumor was located in lobar or segmental bronchi, the tumor response was effective in 76% (42 of 55) of PDT-treated patients and 73% (79 of 108) of Nd-YAG laser-treated patients. With a mortality rate of 0%, the greatest advantage of PDT over Nd-YAG treatment was safety. Considering complications, PDT seems to be useful for obstruction of lobar and segmental bronchus. Nevertheless, when deciding among alternative therapies, physicians treating patients with advanced lung carcinoma should give careful consideration to the benefit and complications of both laser therapies and decide the most suitable modality.
Highlights
Endoscopic surgery using laser is recognized as an effective modality for endobronchial carcinoma
The Japanese government approved the use of this modality for early stage lung carcinoma in October 1995, and reimbursement through the National Health Insurance began in April 1996
In cases in which the tumor was located in lobar or segmental bronchi, the tumor response was effective in 76% (42 of 55) of photodynamic therapy (PDT)-treated patients and 73% (79 of 108) of neodymium yttriumaluminum-garnet (Nd-YAG) laser-treated patients
Summary
Endoscopic surgery using laser is recognized as an effective modality for endobronchial carcinoma. Attention has increasingly been focused on photodynamic therapy (PDT) with photosensitizer, i.e., Photofrin(R). The Japanese government approved the use of this modality for early stage lung carcinoma in October 1995, and reimbursement through the National Health Insurance began in April 1996. The result of PDT for early stage lung carcinoma at our institution.
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