Abstract
Hayata reported the Japanese experience using hematoporphyrin derivative phototherapy (HpD-PT) in the treatment of early stage lung cancer, not visible on chest roentgenogram, within the reach of the bronchoscope, with no evidence of lymph node involvement, and appears confined within the bronchial wall. A total of 19 patients with early stage lung cancer were reported. In all but 1, the cell type was squamous cell carcinoma. Nine of these patients had resection of tumor after HpD-PT while 10 of the patients were considered inoperable due to poor pulmonary function or refusal of surgery. Of the 9 patients who had surgical resection after phototherapy, tumor had completely disappeared by histologic examination in 3. However, in the other 6 patients, microscopic tumor nests were found in the wall of the resected bronchus. In each of the 10 patients who received phototherapy alone, complete tumor remission was observed; no tumor visible at bronchoscopy and cytology and biopsy were negative for cancer. Three of these 10 patients died with no evidence of recurrent tumor. Two other patients died with tumor recurrence demonstrated at autopsy. The 5 remaining patients were still alive and apparently free of disease, ranging from 9 to 49 months. The overall results reported by Hayata are almost identical to the Mayo Clinic experience with early lung cancer. These 2 centers have now treated and accumulated up to 4.5 years of follow-up in approximately 40 patients with early stage lung cancer. The combined results indicate that with the present methods of HpD-PT a complete response can be expected in 50-60% of central bronchogenic cancers which range from in situ to microinvasive. However, curative effects can hardly be expected if the cancer grows beyond the normal muscular layer, cartilage, or the serosa of the tracheobronchial tree.
Published Version
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