RT Journal Article
SR Electronic
T1 Intraoperative photodinamic therapy as a part of combined radical treatment for stage III NSCLC
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 391
VO 38
IS Suppl 55
A1 Andrey Akopov
A1 Anatoly Rusanov
A1 Garry Papayan
A1 Valentina Molodtcova
A1 Margarita Urtenova
A1 Ivan Chistiakov
A1 Nikita Kazakov
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/391.abstract
AB Background: Incomplete resections for lung cancer remain an important problem. To increase the radicalism we proposed an intraoperative photodynamic therapy (PDT) of resection margins.Methods: 16 patients with central NSCLC (12 men, 4 women) were prospectively included in the study (10 – IIIb, 6 – IIIa). Hystological types were: squamous cell – 10, adeno – 4, large cell – 2. At the time of diagnosis all patients were considered as unresectable or inoperable, reasons were tracheal involvement (7), functional intolerance to pneumonectomy (7) and N3 disease (2). Preoperative treatment included three cycles of chemotherapy and two courses of endobronchial PDT. During operation, after lung resection (pneumonectomy – 11, lobectomy – 5) intraoperative PDT of resection margins (bronchial and vascular stumps, mediastinum) was done. Chlorine e6 complex was used as a photosensitizer in dose of 2 mg/kg. The interval between the injection and illumination was 2 hours. Red light at 662±1 nm wavelength was used to achieve a total illumination dose of 250 j/cm2.Results: After preoperative treatment partial response of tumor was achieved in all cases and patients underwent surgery with radical intent. There was no post PDT complication. 14 operations were R0, 2 – R1. No major postoperative complications noted except cardiac arrhythmia in 3 patients (19%). Average period of follow-up was 16 months (4 to 30 months), all patients are alive without any signs of recurrence.Conclusion: The first experience of the combined treatment including intraoperative PDT for locally advanced NSCLC demonstrates safety and effectiveness. Additional studies are needed to proof the value of intraoperative PDT.