Acute effects of combined photodynamic therapy and hyperbaric oxygenation in lung cancer - A clinical pilot study

Background and Objectives: Photodynamic tumor therapy (PDT) is based upon a photochemical reaction that is limited by the availability of molecular ox ygen in the target tissue. The use of hyperbaric oxygenation (HBO) increase s the amount of oxygen available for the process may thereby enhance the ef ficacy of PDT. We investigated the acute effects on tumor stenosis after co mbined PDT/HBO. Patients and Methods: Thirty patients (22 males, 8 females, mean age: 68.8 years; range: 44-78 years) with inoperable non-small cell bronchogenic carc inoma and endobronchial stenosis were studied prospectively. Photosensitiza tion was carried out using a hematoporphyrin-derivative 2 mg/kg BW 48 hours prior to PDT. The light dose was calculated as 300 J/cm fiber tip. The ass essment of outcome 1 and 4 weeks after PDT/HBO was performed by endoscopy, chest X-ray, spirometry, laboratory parameters, subjective report of dyspne a, and Karnofsky performance status. Results: At one and four weeks after the treatment, the patients felt a sig nificant improvement of dyspnea and hemoptysis along with an objective subs iding of poststenotic pneumonia, though spirometric parameters revealed no significant difference. A significant reduction of tumor stenosis (P < 0.05 ) and an improvement of the Karnofsky performance status (P < 0.05) were do cumented 1 and 4 weeks after PDT/HBO. No therapy related complications were observed. Conclusion: Although the small number of patients does not allow to draw de finitive conclusions to be drawn, the results suggests that combined PDT/HB O represents a new, safe, and technically feasible approach. It enables eff icient and rapid reduction of the endoluminal tumor load and helps conditio ning the patient for further treatment procedures. (C) 2001 Wiley-Liss, Inc .