Photodynamic Theranostics of Central Lung Cancer: Capabilities of Early Diagnosis and Minimally Invasive Therapy (Review)

Abstract

The aim of the study was to assess the prospects for central lung cancer (CLC) screening using fluorescent diagnostics and its treatment by endobronchial photodynamic therapy (PDT).Bronchoscopic fluorescent diagnostics using chlorin e6 photosensitizers and a developed instrumental system enable to reveal tumor changes in large bronchi mucosa at early stages, and a developed PDT technique performed under fluorescent control helps achieve personalized treatment. Such an approach is considered as a theranostic technique -photodynamic theranostics.Central lung cancer screening requires a fluorescent dye characterized by availability and can be used directly within the examination. Indocyanine green can be used as a dye, its peculiarity is the necessity to excite and record fluorescence in the near-infrared (NIR) wavelength band. First experiments using NIR bands to diagnose a bronchoscopic system showed the detectability of tumor areas using on-site bronchoscopic photodynamic theranostics, which consists in NIR imaging of tumor foci when a standard dose of indocyanine green is administered during the examination.Conclusion. Further progress of early diagnostics and minimally invasive CLC therapy will be determined by the development of new photosensitizers, which should be characterized by a high absorption band in NIR area, quick accumulation in a tumor, high yield of single oxygen in NIR illumination, bright fluorescence, high potential in terms of the induction of an anti-tumor immune response.

Bibliometric and visual analysis of photodynamic therapy for lung cancer from 2010 to 2022

“…However, there is considerable uncertainty concerning LDCT in that it may lead to patients passively receiving radiation exposure during scanning. Additionally, the benefits and costs of LDCT are not proportional to conventional thresholds ( 38 ). Bronchoscopic fluorescence diagnosis using photosensitizers and other instrumental systems can facilitate the early revelation of tumor changes in the large bronchial mucosa, and the development of PDT technology performed under fluorescence control can contribute to the realization of personalized treatment and is considered to be a photodynamic therapeutic diagnostics technique ( 39 ).…”