Federal Medical Center, Butner, North Carolina, 27509, USA.
Interventional Pulmonology, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
Photodiagnosis Photodyn Ther. 2022 Sep;39:103001. doi: 10.1016/j.pdpdt.2022.103001. Epub 2022 Jul 6.
Photodynamic therapy (PDT) is an FDA approved treatment for lung cancer. In the United States the photosensitizer porfimer sodium (Photofrin®, Pinnacle Biologics) is intravenously introduced at 2mg/kg. After approximately 48 h, illumination to activate the photosensitizer is initiated, with 630nm red light at 200J/cm, delivered by fiber-optic catheter, brought to the tumor endo- bronchially, and delivered for 500 s. This will create, in the presence of oxygen, a Type II Photodynamic Reaction (PDR) which generates singlet oxygen species that are tumor ablative. Classically, PDT for lung cancer has been employed for symptomatic central and obstructing tumors with great success. This case report describes an innovative approach to treat a peripheral, early stage lung cancer employing magnetic navigation and endobronchial treatment. We report on a 79 year old male with numerous comorbidities including pulmonary fibrosis, who was found to have a biopsy proven peripheral and solitary non-small cell cancer. Due to prior SBRT (stereotactic body radiation therapy) with dose levels causing radiation fibrosis, he was not a candidate for repeat SBRT, and he was not a surgical candidate due to comorbidities. Tumor control with PDT was achieved without treatment related morbidity. This report details our findings.
光动力疗法（PDT）是一种获得美国食品和药物管理局（FDA）批准的肺癌治疗方法。在美国，静脉内注射的光敏剂是卟啉钠（Photofrin®，Pinnacle Biologics），剂量为 2mg/kg。大约 48 小时后，开始用 630nm 红光进行光照以激活光敏剂，光强为 200J/cm，通过光纤导管将其输送到肿瘤的支气管内，并持续 500 秒。在有氧气的情况下，这将产生 II 型光动力反应（PDR），生成具有肿瘤消融作用的单线态氧。经典的 PDT 治疗肺癌，主要针对有症状的中央型和阻塞型肿瘤，效果非常显著。本病例报告描述了一种采用磁导航和支气管内治疗的创新方法，用于治疗外周性早期肺癌。我们报告了一名 79 岁的男性患者，他患有多种合并症，包括肺纤维化，经活检证实患有外周性和孤立性非小细胞肺癌。由于之前的立体定向体放射治疗（SBRT）剂量水平导致放射性纤维化，他不适合重复 SBRT，由于合并症也不适合手术。PDT 治疗控制了肿瘤，且无治疗相关并发症。本报告详细介绍了我们的发现。
