Corti Luigi, Toniolo Lamberto, Boso Caterina, Colaut Flavio, Fiore Davide, Muzzio Pier-Carlo, Koukourakis Michael I, Mazzarotto Renzo, Pignataro Michele, Loreggian Lucio, Sotti Guido
Department of Radiotherapy, IOV-IRCCS, Padua, Italy.
Lasers Surg Med. 2007 Jun;39(5):394-402. doi: 10.1002/lsm.20513.
The role of photodynamic therapy (PDT) in the treatment of small cancers has been established in several clinical studies. Here, we report on the efficacy of PDT for early inoperable or recurrent non-small-cell lung cancer (NSCLC).
From June 1989 to November 2004, 40 patients with 50 NSCLC were treated with PDT. Twelve cases were inoperable for medical reasons and were staged as T1N0M0, and 28 had recurrent in situ carcinoma. Patients with residual disease after PDT received definitive radiotherapy and/or brachytherapy. Follow-up ranged from 6 to 167 months (median 43.59). Twenty of the 40 patients received i.v. injections of hematoporphyrin derivative (5 mg/kg), the other 20 had injections of porfimer sodium (Photofrin, 2 mg/kg). An argon dye laser (630 nm wavelength, 200-300 J/cm2) was used for light irradiation in 24 of the 40 patients, a diode laser (Diomed, 630 nm wavelength, 100-200 J/cm2) in the other 16.
PDT obtained a 72% complete response (CR) rate (36/50 treated lesions), that is 27 CR among the 37 Tis carcinomas and 9 among the 13 T1 cases. Kaplan-Meier curves showed a mean overall survival (OS) of 75.59 months (median 91.4 months). Two- and 5-year OS rates were 72.78% and 59.55%. The mean and median survival rates for patients with Tis stage were 86.5 and 120.4 months, respectively (standard error 9.50) and for patients with T1 disease they were 45.78 and 35.71 months, respectively; the difference was statistically significant (P = 0.03). No severe early or late PDT-related adverse events were recorded.
PDT is effective in early primary or recurrent NSCLC, resulting in a CR rate of 72%. The incorporation of PDT in standard clinical practice, in combination with radiotherapy, warrants further investigation.
光动力疗法（PDT）在小癌症治疗中的作用已在多项临床研究中得到证实。在此，我们报告PDT治疗早期无法手术或复发性非小细胞肺癌（NSCLC）的疗效。
1989年6月至2004年11月，40例患有50处NSCLC的患者接受了PDT治疗。12例因医学原因无法手术，分期为T1N0M0，28例为复发性原位癌。PDT后有残留病灶的患者接受了根治性放疗和/或近距离放疗。随访时间为6至167个月（中位时间43.59个月）。40例患者中有20例静脉注射血卟啉衍生物（5mg/kg），另外20例注射卟吩姆钠（光卟啉，2mg/kg）。40例患者中有24例使用氩染料激光（波长630nm，200 - 300J/cm²）进行光照射，另外16例使用二极管激光（Diomed，波长630nm，100 - 200J/cm²）。
PDT获得了72%的完全缓解（CR）率（50处治疗病灶中有36处），即37处Tis癌中有27处CR，13处T1病例中有9处CR。Kaplan - Meier曲线显示平均总生存期（OS）为75.59个月（中位时间91.4个月）。2年和5年OS率分别为72.78%和59.55%。Tis期患者的平均和中位生存率分别为86.5个月和120.4个月（标准误差9.50），T1期疾病患者的平均和中位生存率分别为45.78个月和35.71个月；差异具有统计学意义（P = 0.03）。未记录到与PDT相关的严重早期或晚期不良事件。
PDT对早期原发性或复发性NSCLC有效，CR率达72%。将PDT纳入标准临床实践并与放疗联合，值得进一步研究。
