Photodynamic therapy for lung cancers based on novel photodynamic diagnosis using talaporfin sodium (NPe6) and autofluorescence bronchoscopy.
BACKGROUND
We had previously developed the possibility of use of a photodynamic diagnosis (PDD) system using a tumor-selective photosensitizer and laser irradiation for the early detection and photodynamic therapy (PDT) for centrally located early lung cancers. Recently, we established the autofluorescence diagnosis system integrated into a videoendoscope (SAFE-3000) as a very useful technique for the early diagnosis of lung cancer.


METHODS
Twenty-nine patients (38 lesions) with centrally located early lung cancer received PDD and PDT using the second-generation photosensitizer, talaporfin sodium (NPe6). Just before the PDT, we defined the tumor margin accurately using the novel PDD system SAFE-3000 with NPe6 and a diode laser (408nm).


RESULTS
Red fluorescence emitted from the tumor by excitation of the photosensitizer by the diode laser (408nm) from SAFE-3000 allowed accurate determination of the tumor margin just before the PDT. The complete remission (CR) rate following NPe6-PDT in the cases with early lung cancer was 92.1% (35/38 lesions). We also confirmed the loss of red fluorescence from the tumors immediately after the PDT using SAFE-3000. We confirmed that all the NPe6 in the tumor had been excited and photobleached by the laser irradiation (664nm) and that no additional laser irradiation was needed for curative treatment.


CONCLUSIONS
This novel PDD system using SAFE-3000 and NPe6 improved the quality and efficacy of PDT and avoided misjudgement of the dose of the photosensitizer or laser irradiation in PDT. PDT using NPe6 will become a standard option of treatments for centrally located early lung cancer.
Usuda
Jitsuo
J
Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo 160-0023, Japan. jusuda@tokyo-med.ac.jp
Tsutsui
Hidemitsu
H
Honda
Hidetoshi
H
Ichinose
Shuji
S
Ishizumi
Taichirou
T
Hirata
Takeshi
T
Inoue
Tatsuya
T
Ohtani
Keishi
K
Maehara
Sachio
S
Imai
Kentarou
K
Tsunoda
Yoshihiko
Y
Kubota
Mitsuhiro
M
Ikeda
Norihiko
N
Furukawa
Kinya
K
Okunaka
Tetsuya
T
Kato
Harubumi
H
D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000009:adverse effects; D011166:Porphyrins / Q000009:adverse effects / Q000627:therapeutic use*
D011166:Porphyrins; C053434:Talaporfin