Cortese D A, Edell E S, Kinsey J H
Division of Thoracic Diseases and Internal Medicine, Mayo Clinic Jacksonville, Florida, USA.
Mayo Clin Proc. 1997 Jul;72(7):595-602. doi: 10.1016/S0025-6196(11)63563-5.
To study the effectiveness of photodynamic therapy (PDT) as a therapeutic strategy in roentgenographically occult squamous cell carcinoma of the lung.
A carefully selected group of 21 patients (with 23 cancers) who had early stage squamous cell carcinoma of the lung and were eligible for surgical treatment were offered PDT as an alternative to resection. Patients underwent close follow-up with bronchoscopic surveillance and were offered resection if cancer persisted after no more than two sessions of PDT.
A complete response was identified in 15 patients (16 cancers) after an initial PDT session. A complete response that lasted longer than 12 months was noted in 11 patients (52%). After PDT, the minimal follow-up period was 24 months. A subsequent primary lung cancer developed in 5 of the 21 patients (24%). Ten patients ultimately had surgical treatment, in 3 (30%) of whom N1 disease was identified at the time of resection. Two patients refused a surgical procedure and received alternative therapy. Therefore, nine patients (43%) were spared an operation (95% confidence interval, 21.8 to 66.6%). The mean duration of follow-up for these nine patients was 68 months (range, 24 to 116).
On the basis of this investigation, we can conclude with 95% confidence that at least 22% of patients with early stage squamous cell lung cancer who are candidates for PDT can be spared surgical resection.
研究光动力疗法（PDT）作为一种治疗策略在X线隐匿性肺鳞状细胞癌中的有效性。
精心挑选了一组21例（共23处癌灶）早期肺鳞状细胞癌且适合手术治疗的患者，为其提供PDT作为手术切除的替代方案。患者接受支气管镜监测密切随访，若在不超过两次PDT治疗后癌症仍持续存在，则进行手术切除。
初次PDT治疗后，15例患者（16处癌灶）出现完全缓解。11例患者（52%）出现持续超过12个月的完全缓解。PDT治疗后，最短随访期为24个月。21例患者中有5例（24%）随后发生原发性肺癌。10例患者最终接受了手术治疗，其中3例（30%）在切除时发现有N1期疾病。2例患者拒绝手术并接受了其他治疗。因此，9例患者（43%）免于手术（95%置信区间为21.8%至66.6%）。这9例患者的平均随访时间为68个月（范围为24至116个月）。
基于本研究，我们有95%的把握得出结论，至少22%适合PDT治疗的早期肺鳞状细胞癌患者可免于手术切除。
