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Ann Thorac Surg 1989;47:693-699
© 1989 The Society of Thoracic Surgeons

Articles

Bronchoscopic phototherapy at comparable dose rates: Early results

Harvey I. Pass, MD*, Thomas Delaney, MD, Paul D. Smith, PhD, Robert Bonner, PhD, Angelo Russo, MD, PhD

Thoracic Oncology Section and Experimental Phototherapy Section, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA

* Address reprint requests to Dr Pass, Surgery Branch, National Cancer Institute/NIH, Bldg 10, Room 2B07, Bethasda, MD 20892.

Photodynamic therapy is a recently introduced treatment for surface malignancies. Since January 1987, 10 patients with endobronchial neoplasms have had bronchoscopic photodynamic therapy at similar dose rates (400 mW/cm) for total atelectasis (2), carinal narrowing with respiratory insufficiency (2), or partial obstruction without collapse (4). Two patients underwent photodynamic therapy as a preliminary to immunotherapy. Histologies included endobronchial metastases (colon, ovary, melanoma, and sarcoma, 1 each; and renal cell, 3) and primary lung cancer (3). The 2 patients with total atelectasis had complete reexpansion after photodynamic therapy, which permitted eventual sleeve lobectomy in 1. Carinal narrowing was ameliorated in the 2 patients seen with inspiratory stridor, thereby permitting hospital discharge. Endoscopically resected fragments after photodynamic therapy exhibited avascular necrosis. These data support further controlled studies of photodynamic therapy by thoracic surgical oncologists to define its limitations as well as to improve and expand its efficacy as a palliative or surgical adjuvant.




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