Photodynamic therapy and/or external beam radiation therapy for roentgenologically occult lung cancer.
METHODS
Thirty-nine roentgenologically occult lung cancers in 29 patients were treated using photodynamic therapy (PDT) and/or thoracic radiotherapy (TRT) from January 1986 to March 1992. With the exception of one mixed-tumor case, all were squamous cell carcinomas.


RESULTS
Initial PDT achieved complete responses in 25 of 39 (64%) of the cancers. Of the remaining 14 cancers that showed less than complete response (CR), 10 of the 14 (71.4%) showed a CR when subsequently treated with TRT, yielding an overall CR rate of 89.7% for cancers treated. Although nine patients experienced recurrences, six of these had CR when treated with PDT and/or TRT. To date, 22 patients are alive. Causes of death in the patients enrolled in this study are as follows: pyothorax (2); heart failure due to pulmonary hypertension (1); chronic respiratory insufficiency (1); subsequent primary brain cancer (1); and subsequent primary lung cancer (1). Only one died of primary lung cancer.


CONCLUSIONS
These findings suggest that PDT and/or TRT may be used as an alternative to surgery in the treatment of selected patients with roentgenologically occult lung cancer.
Imamura
S
S
Department of Pathology, Kumamoto University School of Medicine, Japan.
Kusunoki
Y
Y
Takifuji
N
N
Kudo
S
S
Matsui
K
K
Masuda
N
N
Takada
M
M
Negoro
S
S
Ryu
S
S
Fukuoka
M
M
D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology; D002278:Carcinoma in Situ / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D017324:Hematoporphyrin Derivative / Q000627:therapeutic use*; D006801:Humans; D053685:Laser Therapy; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D010778:Photochemotherapy / Q000009:adverse effects / Q000379:methods; D012074:Remission Induction; D015996:Survival Rate
D017324:Hematoporphyrin Derivative