Efficacy and safety of photodynamic therapy versus Nd‐YAG laser resection in NSCLC with airway obstruction

Díaz-Jiménez, José Pablo; Martínez-Ballarín, J E; Llunell, A.; Farrero, Eva; Rodríguez, Alicia; Castro, María Jesús Pena

doi:10.1034/j.1399-3003.1999.14d13.x

Cited by 117 publications

(68 citation statements)

References 23 publications

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“…Three articles reported the results of studies comparing PDT with neodynium yttrium aluminium garnet (Nd YAG) laser in patients with advanced lung cancer and substantial endoluminal obstruction [11,19,21]. These involved 267 patients randomised to PDT and Nd YAG laser treatment.…”

Section: Group 1: Patients With Advanced Diseasementioning

confidence: 99%

“…Skin photosensitivity (sunburn) has been referred to in most of the reviewed papers ranging 5-28% [21,22]. In almost all cases the severity of skin photosensitivity reaction was considered to be mild (grade 1 skin burn).…”

Section: Group 1: Patients With Advanced Diseasementioning

confidence: 99%

“…By design most authors have treated only nonsmall-cell cancer. However, a few patients with small-cell lung cancer were submitted to PDT with an equal success rate to that of nonsmall-cell lung cancer (NSCLC) cases [21,23].…”

Section: Group 1: Patients With Advanced Diseasementioning

confidence: 99%

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Is bronchoscopic photodynamic therapy a therapeutic option in lung cancer?

Moghissi¹,

Dixon²

2003

Eur Respir J

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This study addresses whether photodynamic therapy (PDT) is a valid therapeutic option in lung cancer treatment.A total of 24 articles were reviewed in two categories: advanced (G1) and early (G2) disease. Details considered included the following: 1) number of patients in each series; 2) staging; 3) methodology; 4) mortality; 5) morbidity; 6) survival; 7) relief of symptoms; and 8) concomitant treatments. G1 (636 patients) had severe endobronchial obstructive cancer and PDT was primarily for symptom relief. G2 (517 patients) had early stage cancer and were treated with PDT for curative intent.There was no procedure-related mortality in either group. G1 had a 5-28% incidence of skin sensitivity. Haemoptysis occurred in two series; one fatal, an incidence of 2.2%. Almost all patients had symptomatic relief. Patients with lower disease stage and better performance status had improved survival rates. G2 had a 8-28% incidence of sunburn. Three patients in one series (38 patients) had haemoptysis. Survival after 5 yrs in complete remission/response patients was 70%.This review suggests that bronchoscopic photodynamic therapy has indications in selected lung cancer patients with early or advanced stage disease. However, in the absence of a formal comparative study, no claim can be made of its superiority over other endobronchial therapies. In the case of lung cancer, PDT refers to the endoscopic treatment of tumour, the location and extent of which is first assessed bronchoscopically. A photosensitiser is then administered to the patient by i.v. injection. This is followed, after an interval, by illumination of the presensitised tumour by an appropriate laser light, which is delivered to the target tissue via an optical fibre through the bronchoscope. The light and chemical interaction leads to necrosis of the tumour.Using the above principle, after experimental and preclinical work, KATO [2] used PDT for the first time in 1980 to treat a patient with early lung cancer who refused surgical intervention. Following bronchoscopic PDT, the patient had complete remission (CR) for 4 yrs and died later from a noncancer related cause.The last 20 yrs has seen many publications on PDT for lung cancer showing its therapeutic usefulness in different stages of the disease. In spite of this, in Europe at least, PDT has not become a mainstream lung cancer treatment option even though there is desperate need for newer therapeutic methods other than the traditional trio of surgery, radiotherapy and chemotherapy. It is generally acknowledged that surgical and oncological advances over the past 40-50 yrs have had little impact on either early detection, resection rate or on survival of lung cancer patients.With this background the authors undertook a review of the literature to evaluate the current state of PDT and to discuss the place of PDT for lung cancer treatment within the overall therapeutic options. Material and methodsA literature search was made through Medline (PubMed) for listed articles on PDT in broncho-pulmonary ...

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Section: Group 1: Patients With Advanced Diseasementioning

confidence: 99%

Section: Group 1: Patients With Advanced Diseasementioning

confidence: 99%

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Is bronchoscopic photodynamic therapy a therapeutic option in lung cancer?

Moghissi¹,

Dixon²

2003

Eur Respir J

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“…Palliative treatment of obstructive cancer with HpD or porfimer sodium PDT was safe and resulted in symptom relief in almost all patients [96][97][98][99]. Side effects, in addition to skin photosensitivity, included cough, expectoration of necrotic debris, and dyspnea for a few days after PDT.…”

Section: Endobronchial Cancermentioning

confidence: 99%

Photodynamic Therapy in Oncology

Triesscheijn¹,

et al. 2006

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Photodynamic therapy (PDT) is increasingly being recognized as an attractive, alternative treatment modality for superficial cancer. Treatment consists of two relatively simple procedures: the administration of a photosensitive drug and illumination of the tumor to activate the drug. Efficacy is high for small superficial tumors and, except for temporary skin photosensitization, there are no long-term side effects if appropriate protocols are followed. Healing occurs with little or no scarring and the procedure can be repeated without cumulative toxicity. Considering the efficacy and lack of long-term toxicity of PDT, and the fact that the first treatment of cancer with PDT was done more than 100 years ago, one might expect that this treatment had already become an established therapy. However, PDT is currently offered in only a few selected centers, although it is slowly gaining acceptance as an alternative to conventional cancer therapies. Here, we show the developmental steps PDT underwent and summarize the current clinical applications. The data show that, when properly used, PDT is an effective alternative treatment option in oncology. The

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“…Prospektif randomize kontrollü bir çalışmada, FDT (N=14 hasta) ve Nd: YAG lazer (N=17 hasta) karşılaştı-rılmıştır. FDT ile tedavi edilen hastalarda, semptomatik iyileşme daha kalıcı, daha uzun süreli (p = 0.03) ve ortalama sağ kalım daha yüksek saptanmıştır (p = 0.007) (8). FDT, eksternal radyoterapi ve brakiterapi ile kombine kullanılabilir.…”

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Photodynamic Therapy for Lung Cancer

Çalışkan¹,

Okutan²,

Taş³

et al. 2017

Respir Case Rep

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ÖzetFotodinamik tedavi (FTD), illüminasyon için kullanılan diyot lazer ile aktive edilen fotosensitizör ilacın hastaya verildiği bir tedavi yöntemidir. Erken evre ve endobronşiyal kritik darlığı olmayan ileri evre akciğer kanserlerinin tedavisinde kullanılmaktadır. FDT uygulaması, etkinliği, komplikasyonları ve endikasyonları kısaca anlatılmıştır.Anahtar Sözcükler: Fotodinamik tedavi, akciğer kanseri, endobronşiyal tedavi. AbstractPhotodynamic therapy (PDT) is a method of treatment in which photosensitizer drug is administered to the patient and activated by diode laser used for illumination. It is used for treatment of advanced lung cancer without endobronchial critical stenosis and for early stage lung cancer. PDT application, efficacy, complications, and indications are briefly explained. Key words: Photodynamic therapy, lung cancer, endobronchial treatment.Fotodinamik tedavi (FDT), hedef hücreleri (kanseröz veya prekanseröz) yok etmek için ışığa duyarlı ilaç (fotosensitizör) ile kombine görülebilir dalga boyunda ışık kullanılan bir tedavi yöntemidir. Uygulaması kolay bir tedavidir ve oldukça güvenilir tümör ablasyon imkânı sağlar. Torasik maligniteler için diğer onkolojik tedaviler ile kombine kullanılabilir. Akciğer kanserinde ilk bronkoskopik FDT, Hayata ve ark. (1) tarafından 1982 yılında uygulanmıştır. Erken evre ve ileri evre, kısmen endobronşiyal obstrüksiyon yapan küçük hücreli dışı akciğer kanseri (KHDAK) tedavisinde FDT kullanımı Amerika Birleşik Devletleri'nde, 1998 yılında onaylanmıştır.FDT uygulamasında, fotosensitizör (FS) ilaç, işlemden 48 saat önce hastaya verilir. İlaç, özel yoğunluk ve dalga boyundaki illüminasyon ile aktive olur ve ablatif fotodinamik reaksiyon gerçekleşir. İllüminasyon için diyot lazer kullanılır. Işık enerjisi ile fotosensitizör aktive olunca, tip II fotokimyasal reaksiyon meydana gelir ve hücresel sitotoksisiteyi düzenleyen reaktif tekil oksijen ( 1 O2) oluşur. Bir ilacın, FS olması için, oksijen bağımlı tip II reaksiyona neden olması gerekir. FS, ışık salınımı ile enerji kaybeder ve buna floresans denir (2). FDT, tümörün damarsal yapılarına hasar ile ve hücrede apoptozis veya nekroz ile direkt tümör hücre ölümü sağlar (3).

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Efficacy and safety of photodynamic therapy versus Nd‐YAG laser resection in NSCLC with airway obstruction

Cited by 117 publications

References 23 publications

Is bronchoscopic photodynamic therapy a therapeutic option in lung cancer?

Is bronchoscopic photodynamic therapy a therapeutic option in lung cancer?

Photodynamic Therapy in Oncology

Photodynamic Therapy for Lung Cancer

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