The place of bronchoscopic photodynamic therapy in advanced unresectable lung cancer: experience of 100 cases1

Moghissi, K.; Dixon, Kate; Stringer, Maurice; Freeman, Tami; Thorpe, Andrew; Brown, Stanley B.

doi:10.1016/s1010-7940(98)00295-4

Cited by 141 publications

(76 citation statements)

References 10 publications

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“…The majority of authors carry out PDT under topical anaesthesia, though some have used general anaesthesia [6,17,18,22,24]. All authors used a flexible fibreoptic bronchoscope for visualisation and placement of the optical fibre, which was passed through the biopsy channel of the instrument to the target tissue.…”

Section: Procedure/instrumentationmentioning

confidence: 99%

“…Some, in the presence of bulky tumours, carry out routine bronchoscopic debridement immediately after illumination and from 1-5 days later, to remove debris, mucus and fibin clot mixed with necrotic tumour [17,22]. Many clean up bronchoscopies were carried out with a second illumination of the residual tumour.…”

Section: Procedure/instrumentationmentioning

confidence: 99%

“…Skin photosensitivity (sunburn) has been referred to in most of the reviewed papers ranging 5-28% [21,22]. In almost all cases the severity of skin photosensitivity reaction was considered to be mild (grade 1 skin burn).…”

Section: Group 1: Patients With Advanced Diseasementioning

confidence: 99%

“…The improvement was matched objectively by amelioration of ventilatory function, with relief of dyspnoea and cough. Two of the larger series of patients in this group, with a total of 275 patients, have reported that survival after PDT in patients with advanced disease depends largely on stage of disease and the patients9 performance status (PS) [17,22]. Patients with PS (World Health Organisation (WHO) scale) of o3 [17] or those with Karnofsky v50 [22], had worse survival than those with better PS for similar tumour stage.…”

Section: Group 1: Patients With Advanced Diseasementioning

confidence: 99%

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Is bronchoscopic photodynamic therapy a therapeutic option in lung cancer?

Moghissi¹,

Dixon²

2003

Eur Respir J

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This study addresses whether photodynamic therapy (PDT) is a valid therapeutic option in lung cancer treatment.A total of 24 articles were reviewed in two categories: advanced (G1) and early (G2) disease. Details considered included the following: 1) number of patients in each series; 2) staging; 3) methodology; 4) mortality; 5) morbidity; 6) survival; 7) relief of symptoms; and 8) concomitant treatments. G1 (636 patients) had severe endobronchial obstructive cancer and PDT was primarily for symptom relief. G2 (517 patients) had early stage cancer and were treated with PDT for curative intent.There was no procedure-related mortality in either group. G1 had a 5-28% incidence of skin sensitivity. Haemoptysis occurred in two series; one fatal, an incidence of 2.2%. Almost all patients had symptomatic relief. Patients with lower disease stage and better performance status had improved survival rates. G2 had a 8-28% incidence of sunburn. Three patients in one series (38 patients) had haemoptysis. Survival after 5 yrs in complete remission/response patients was 70%.This review suggests that bronchoscopic photodynamic therapy has indications in selected lung cancer patients with early or advanced stage disease. However, in the absence of a formal comparative study, no claim can be made of its superiority over other endobronchial therapies. In the case of lung cancer, PDT refers to the endoscopic treatment of tumour, the location and extent of which is first assessed bronchoscopically. A photosensitiser is then administered to the patient by i.v. injection. This is followed, after an interval, by illumination of the presensitised tumour by an appropriate laser light, which is delivered to the target tissue via an optical fibre through the bronchoscope. The light and chemical interaction leads to necrosis of the tumour.Using the above principle, after experimental and preclinical work, KATO [2] used PDT for the first time in 1980 to treat a patient with early lung cancer who refused surgical intervention. Following bronchoscopic PDT, the patient had complete remission (CR) for 4 yrs and died later from a noncancer related cause.The last 20 yrs has seen many publications on PDT for lung cancer showing its therapeutic usefulness in different stages of the disease. In spite of this, in Europe at least, PDT has not become a mainstream lung cancer treatment option even though there is desperate need for newer therapeutic methods other than the traditional trio of surgery, radiotherapy and chemotherapy. It is generally acknowledged that surgical and oncological advances over the past 40-50 yrs have had little impact on either early detection, resection rate or on survival of lung cancer patients.With this background the authors undertook a review of the literature to evaluate the current state of PDT and to discuss the place of PDT for lung cancer treatment within the overall therapeutic options. Material and methodsA literature search was made through Medline (PubMed) for listed articles on PDT in broncho-pulmonary ...

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Section: Procedure/instrumentationmentioning

confidence: 99%

Section: Procedure/instrumentationmentioning

confidence: 99%

Section: Group 1: Patients With Advanced Diseasementioning

confidence: 99%

Section: Group 1: Patients With Advanced Diseasementioning

confidence: 99%

See 2 more Smart Citations

Is bronchoscopic photodynamic therapy a therapeutic option in lung cancer?

Moghissi¹,

Dixon²

2003

Eur Respir J

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“…4 All of the studies in advanced lung cancer were considered to be of poor quality. Three of them compared PDT with a neodymium:yttrium-aluminum-garnet (NdYAG) laser, and 2 compared radiotherapy with radiotherapy plus PDT; in the latter 2, a possible benefit was seen in the PDT group.…”

Section: Lung Cancermentioning

confidence: 99%

How Mainstream Medicine Sees Photodynamic Therapy in the United Kingdom

Bown

2012

J Natl Compr Canc Netw

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Although photodynamic therapy (PDT) has been used successfully to treat an assortment of different types of cancer, it has yet to reach the level of mainstream medicine on either side of the Atlantic. Unsubstantiated claims of PDT's efficacy in the past may be part of the reason for this. However, perhaps the main obstacle to PDT's endorsement by conventional medicine is the limited number of high-quality randomized controlled trials (RCTs) comparing it with relevant comparators for all meaningful outcomes, including effectiveness, safety, adverse events, quality of life, survival, and cost. Based on a Health Technology Assessment report on the current status of PDT and consultation with professional groups, specialist societies, and clinical study groups in the United Kingdom, this article explores the current clinical guidelines for use of PDT in cancer treatment and the dearth of supportive data from RCTs. (

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Photodynamic Therapy for Endobronchial Tumors: Palliation and Definitive Therapy

Ost¹

2006

Thoracic Endoscopy: Advances in Interventional Pulmonology

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The place of bronchoscopic photodynamic therapy in advanced unresectable lung cancer: experience of 100 cases1

Abstract: (1) PDT is effective in palliation of inoperable advanced lung cancer. (2) Subset of patients with a better performance status have added survival benefit.

Cited by 141 publications

References 10 publications

Is bronchoscopic photodynamic therapy a therapeutic option in lung cancer?

Is bronchoscopic photodynamic therapy a therapeutic option in lung cancer?

How Mainstream Medicine Sees Photodynamic Therapy in the United Kingdom

Photodynamic Therapy for Endobronchial Tumors: Palliation and Definitive Therapy

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