PHOTODYNAMIC THERAPY AND OR EXTERNAL-BEAM RADIATION-THERAPY FOR ROENTGENOLOGICALLY OCCULT LUNG-CANCER/

Background and Methods. Thirty-nine roentgenologically occult lung can cers in 29 patients were treated using photodynamic therapy (PDT) and/ or thoracic radiotherapy (TRT) from January 1986 to March 1992. With t he exception of one mixed-tumor case, all were squamous cell carcinoma s. Results. Initial PDT achieved complete responses in 25 of 39 (64%) of the cancers. Of the remaining 14 cancers that showed less than comp lete response (CR), 10 of the 14 (71.4%) showed a CR when subsequently treated with TRT, yielding an overall CR rate of 89.7% for cancers tr eated. Although nine patients experienced recurrences, six of these ha d CR when treated with PDT and/or TRT. To date, 22 patients are alive. Causes of death in the patients enrolled in this study are as follows : pyothorax (2); heart failure due to pulmonary hypertension (1); chro nic respiratory insufficiency (1); subsequent primary brain cancer (1) ; and subsequent primary lung cancer (1). Only one died of primary lun g cancer. Conclusions. These findings suggest that PDT and/or TRT may be used as an alternative to surgery in the treatment of selected pati ents with roentgenologically occult lung cancer.