PHOTODYNAMIC THERAPY FOR EARLY-STAGE SQUAMOUS-CELL CARCINOMA OF THE LUNG

Objective: To study the effectiveness of photodynamic therapy (PDT) as a therapeutic strategy in roentgenographically occult squamous cell c arcinoma of the lung. Material and Methods: A carefully selected group of 21 patients (with 23 cancers) who had early stage squamous cell ca rcinoma of the lung and were eligible for surgical treatment were offe red PDT as an alternative to resection. Patients underwent close follo wup with bronchoscopic surveillance and were offered resection if canc er persisted after no more than two sessions of PDT. Results: A comple te response was identified in 15 patients (16 cancers) after an initia l PDT session. A complete response that lasted longer than 12 months w as noted in 11 patients (52%). After PDT, the minimal follow-up period was 24 months, A subsequent primary lung cancer developed in 5 of the 21 patients (24%), Ten patients ultimately had surgical treatment, in 3 (30%) of whom N1 disease was identified at the time of resection, T wo patients refused a surgical procedure and received alternative ther apy, Therefore, nine patients (43%) were spared an operation (95% conf idence interval, 21.8 to 66.6%). The mean duration of follow-up for th ese nine patients was 68 months (range, 24 to 116). Conclusion: On the basis of this investigation, me can conclude with 95% confidence that at least 22% of patients with early stage squamous cell lung cancer w ho are candidates for PDT can be spared surgical resection.