Place of cryotherapy, brachytherapy and photodynamic therapy in therapeutic bronchoscopy of lung cancers

Therapy of exophytic bronchial tumorous stenosis by flexible cryoprobe

“…We read with interest the article by VERGNON et al [1] in the European Respiratory Journal, about the place of cryotherapy, brachytherapy and photodynamic therapy in the therapeutic bronchoscopy of lung cancers. The article describes indications and limitations of cryotherapy.…”

“…The article describes indications and limitations of cryotherapy. In the opinion of VERGNON et al [1], the effect of cryotherapy is delayed and is, therefore, not useful for the immediate debulking of an obstructive endoluminal bronchial tumour. For these cases, VERGNON et al [1] advise coring of the tumour with the rigid bronchoscope and subsequent laser therapy or electrocautery.…”

“…In the opinion of VERGNON et al [1], the effect of cryotherapy is delayed and is, therefore, not useful for the immediate debulking of an obstructive endoluminal bronchial tumour. For these cases, VERGNON et al [1] advise coring of the tumour with the rigid bronchoscope and subsequent laser therapy or electrocautery. The indication for cryotherapy in this setting is seen as a treatment option for any remaining infiltrative parts of the tumour into the bronchial wall, but not as a treatment option of first choice to remove the main part of an exophytic tumour.…”

High Dose Rate Endobronchial Brachytherapy in Lung Cancer in Patients with Central Airway Obstruction

“…In small endobronchial tumors EBBT is used as definitive curative treatment 3 .EBBT is also used for non-oncologic pathologies 4,5 . The majority of non-small cell lung cancer (NSCLC)found at loco-regionally advanced stage and frequently associated with bronchial obstruction Various endoscopic techniques available today are including cryotherapy, stent, laser, photodynamic, and EBBT 6,7 . Among these EBBT in the only one that provides biologically tumoricidal effect keeping the normal tissue structure as is.…”

Should we abandon standard forceps biopsy to diagnose an endobronchial lesion?

“…Shortly thereafter, MATHUR et al [5] and VERGNON et al [6] described its application in the treatment of malignant airway obstruction (palliation) and radio-occult early-stage lung cancer (cure) applying multiple freeze/thaw cycles of ,30 s. More than a decade later, the role of cryotherapy still remains limited compared with other endobronchial treatment techniques. In 2008, HETZEL et al [7] stated the feasibility (sample size and tissue quality) of flexible cryoprobes to harvest tissue for histological diagnosis of exophytic lesions during flexible bronchoscopy.…”