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


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
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