J.Jpn. Surg. Soc.. 88(9): 1221-1224, 1987

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Report on the annual meeting

REDUCTION OF RESECTION EXTENT AND INCREASE IN OPERABILITY BY PREOPERATIVE LASER PHOTOYNAMIC THERAPY IN LUNG CANCER

Fifteen patients with lung cancer were treated by combined preoperative photodynamic therapy and operation. There were 5 cases of tracheal or carinal invasion from primary lesions, and 10 cases of polypoid tumor or invasion of the main bronchus. Argon dye lasers were used as a light source for the hematoporphyrin derivative (HpD) excitation. Preoperative laser photodynamic therapy was performed 48 to 72 hours after intravenous administration of HpD. Therapeutic conditions were 60 to 720 Joules/cm² for the superficial invasive area. Operation was performed 1 to 9 weeks after photodynamic therapy. The initial purpose of photodynamic therapy, i.e., reduction of extent of resection or conversion of inoperable status to operable, was achieved in 12 of 15 patients treated. In 4 of 5 originally inoperable cases, conversion to an operable condition was achieved. Ten patients were originally candidates of pneumomectomy, and it became possible to reduce the extent of resection to lobectomy in 8 of them. Tumor cells were not seen in the resected bronchial margin except in 3 cases and one tumor recurrence has been seen 20 months after treatment. Photodynamic therapy can be indicated in cases of superficial invasion of tumor in the bronchial mucosa in order to reduce the extent of surgery or to make inoperable cases operable.

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