Photodynamic therapy (PDT) for lung cancer: the Yorkshire Laser Centre experience

The Yorkshire Laser Centre team have been engaged in photodynamic therapy (PDT) since 1990. In this article we review our experience in bronchoscopic PDT for lung cancer and outline our current indications and results. 160 patients in 2 groups entered into a prospective study: Group A ( N = 144) were symptomatic with advanced inoperable disease and with presence of >50% bronchial obstruction. Group E ( N = 16) with early stage cancer and presence of superficial lesion confined to bronchial tree. All patients had standard investigation and work-up bronchoscopy and biopsy confirmation of cancer by cyto-histology. PDT method was intravenous administration of 2 mg/kg BW of Photofrin (Porfimer Sodium) followed by bronchoscopic illumination of 630 nm laser light. There was no treatment-related mortality. Nine patients (5.6%) presented with skin photosensitivity reaction and another eight with respiratory complication. Group A: Symptom relief was achieved in all. This was matched by significant improvement in bronchial opening (58.1%). Survival was 9.6 months (mean) and 5 months (median), respectively. This was greater in patients with better performance status and lower stage of disease. Group E: Every patient had a complete response to treatment, some after two treatments. Survival in this group was 75.4 months (mean) and 69 months (median). Bronchoscopic PDT is indicated in both advanced and early stage lung cancer. In the former it provides symptomatic relief in all and survival benefit in some; in the latter it achieves long survival and potential cure.