Photodynamic Therapy an Option in Early Lung Cancer When Surgery Is Not

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NEW YORK (Reuters Health) May 17 - Bronchoscopic photodynamic therapy (PDT) can extend disease-free survival in patients with early central lung cancer, according to a report in the May issue of Thorax.

"When the patient is ineligible for surgery, we regard PDT as a first-line option which, in the case of early stage cancer, has a high rate of success," Dr. Keyvan Moghissi from The Yorkshire Laser Centre, Goole, UK told Reuters Health.

Dr. Moghissi and associates reviewed the Centre's experience in a series of 21 patients whose disease was confined to endobronchial lesions that were technically operable, but who were otherwise ineligible for surgical operation.

All 29 bronchoscopic treatments in the 21 patients were carried out as day case procedures, and no patient required readmission to hospital following PDT or experienced procedure-related or 30-day mortality, the authors report.

All patients achieved complete responses lasting from 2 months to over 5 years, the results indicate.

Seven patients underwent a second PDT procedure at the time of local recurrence of their tumor 6 to 15 months after the first PDT, the researchers note.

Fifteen patients were alive 12 to 82 months after their initial bronchoscopic PDT, the report indicates, and six died (three from non-cancer related causes) from 3 to 103 months (mean, 39.3 months) after the procedure.

"Following bronchoscopic PDT in early central lung cancer, patients should be followed up for life with periodic bronchoscopic examinations because complete response is unpredictable," the investigators say.

"Currently we are seeking funding to organize a multi-center trial of early diagnosis using CT and fluorescence bronchoscopy amongst high risk individuals, with a view to using PDT in early central lung cancer," Dr. Moghissi said.

"There will be a growing need for therapeutic strategies. PDT could be one of them," writes Dr. Lutz Freitag from Hemer, Germany in a related editorial. "However, those of us who do PDT perform it with mixed feelings. In most countries the drug alone costs more than the reimbursement we receive."

"The industry spends incredible amounts of money on chemotherapy drugs," the editorial continues. "It would be appropriate to spend some money on the development and approval of more sophisticated PDT drugs."

Thorax 2007;62:391-395,374-375.

Source: http://www.medscape.com/viewarticle/556686?src=mp