Photodynamic Therapy in Early Lung Cancer: A Report of Two Cases
A 64-year-old Korean man was treated for squamous lung cancer IIIa (T1N2M0) 26 months prior to presentation; he now presented with subepithelial stroma that contained a very tiny nest of squamous cell carcinoma cells in the left upper lobe bronchus. The patient previously, 26 months ago, had surgery to remove the right upper and middle lobes of the lung; the patient received six cycles of adjuvant chemotherapy and chest radiation therapy with 5,520 cGy. We provided PDT at the left upper bronchus with 200J and a 2 cm diffuser for 400 seconds. After 48 hours, there were no necrotic conversions observed but edematous hyperemic mucosal changes were present. At eight months after the first PDT, a nodular mass was noted at the left upper apical segment. The pathology results from a bronchoscopic biopsy identified a squamous cell carcinoma. Light was delivered at 250 J/cm2 with a diffuser length for 625 seconds, and 100 J/cm2 for 250 seconds at the same site and again after 48 hours, respectively. After PDT, there were no immediate complications such as hemoptysis or respiratory failure. We performed a follow up bronchoscopy at one and four months. The previous cancer site showed inflammatory conversion; there was no remnant tumor tissue (). The patient is alive and well at 30 month follow up.