Abstract
Background: Bronchoscopic photodynamic therapy (PDT) is a treatment option for patients with early central lung cancer, especially ineligible for surgical resection. This study aimed to assess the clinical outcomes of curative PDT for patients with central lung carcinoma in situ (CIS). Methods: Five patients with central lung squamous CIS treated by PDT were analyzed. The PDT protocol was as followings: (1) intravenous photosensitizer (Photofrin for 1 patient or Photogem for 4 patients) 2mg/kg followed by bronchoscopic illumination 40–50h later using 630nm laser light, (2) the light dose of 100–200 J/cm with 2 cm length cylindrical type diffuser. Results: The patientswere allmalewithmedian age 70 (67–77). Five patients had each a squamous carcinoma in situ (Tis). Four lesions were synchronously detected with another main primary lung cancer (pathologic stage IA–IB). OneTiswas incidentally found during work-up for segmental lung atelectasis without other primary lung cancer. The rate of complete remission was 100% and median disease free survival (DFS) of PDT site was 74.0 months. There was no serious adverse event related to PDT. Median overall survival was not reached. 4-Year survival rate was 60%. Conclusion: PDT for central lung squamous CIS can achieve acceptable DFS and overall survival.
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