Management of multiple primary lung cancer in patients with centrally located early lung cancer lesions (Conference Presentation)

Abstract

Background: Patients with centrally located early lung cancer (CLELC) are often heavy smokers with a considerably high risk of multiple lung cancer (MPLC) lesions; treatment strategies for such patients must preserve the cardiopulmonary function. Methods: Between June 2013 and June 2018, 10 patients with CLELC underwent photodynamic therapy (PDT) using NPe6, second-generation photosensitizer at Nippon Medical School Hospital. Among these patients, we retrospectively analyzed MPLC which were treated by surgery plus PDT or PDT alone, and examined the effectiveness of PDT and we propose a treatment strategy for patients with MPLC. Results: Eight patients underwent surgery (five lobectomies and three partial resections) for primary lung cancer and then underwent NPe6-PDT for the treatment of secondary primary CLELC, two patients were performed PDT alone. In 6 of these 10 patients, CLELC was found as metachronous lesions and in 4 patients as synchronous lesions using sputum cytology and a bronchoscopical examination using autofluorescence bronchoscopy. All 10 lesions were CLELC and identified by autofluorescence bronchoscopy. Among the 10 patients with MPLC including peripheral-type lung cancers which were resected by surgery, all 10 CLELC lesions exhibited a complete response after PDT. Conclusions: For lung cancer patients with a long-term history of smoking, careful follow-up examinations after surgical resection are needed considering the incidence of metachronous primary lung cancers. PDT can play an important role for the treatment strategy for MPLC.