title: New aspects of photodynamic therapy for central type early stage lung cancer.
abstract: BACKGROUND
  and Objective Photodynamic therapy (PDT) has come to be considered as the first choice of treatment for central type early stage lung cancer (CELC). Recent advances in the ability to diagnose CELC, and in photosensitizers, as well as sophisticated clinical management, may improve the therapeutic outcome and expand the indications of PDT.
  
  
  METHODS
  We made the search for papers on PDT for lung cancer to select the most relevant articles. Based on this review and our recent data, we discussed the best available evidence for the diagnosis, the definition of indications, photosensitizers, and clinical management with regard to PDT.
  
  
  RESULTS
  To obtain complete response (CR) by PDT, the selection of the indications is extremely important, including the extent of the tumor on the bronchial surface and the depth of invasion in the bronchial wall. The development of autofluorescence bronchoscopy (AFB) and endobronchial ultrasonography (EBUS) have had a large impact on diagnostic bronchoscopy for CELC. CELCs less than 1 cm in diameter showed a favorable cure rate by PDT, thus this is a good indication for PDT. The relatively newer photosensitizer NPe6, which has a stronger antitumor effect than Photofrin, showed similar treatment outcome even for large tumors >1.0 cm in diameter. Furthermore, comprehensive management including photodynamic diagnosis before and after PDT should be effective to minimize the possibility of local recurrence after PDT.
  
  
  CONCLUSIONS
  The present guidelines of PDT for CELC were established based on the data obtained from studies in the 1980's. We postulate that comprehensive diagnosis and the new generation of photosensitizers may increase the CR rate and expand the indications of PDT for larger tumors.
authors: Department of Surgery, Tokyo Medical University, Tokyo, Japan. ikeda-n@tokyo-med.ac.jp
authors: Norihiko
authors: N
authors: Ikeda
authors: Jitsuo
authors: J
authors: Usuda
authors: Harubumi
authors: H
authors: Kato
authors: Taichiro
authors: T
authors: Ishizumi
authors: Shuji
authors: S
authors: Ichinose
authors: Keishi
authors: K
authors: Otani
authors: Hidetoshi
authors: H
authors: Honda
authors: Kinya
authors: K
authors: Furukawa
authors: Tetsuya
authors: T
authors: Okunaka
authors: Hidemitsu
authors: H
authors: Tsutsui
mesh_terms: D001999:Bronchoscopy; D002283:Carcinoma, Bronchogenic / Q000175:diagnosis / Q000188:drug therapy*; D017323:Dihematoporphyrin Ether / Q000627:therapeutic use; D019160:Endosonography; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D017410:Practice Guidelines as Topic
chemical_list: D017319:Photosensitizing Agents; D011166:Porphyrins; D017323:Dihematoporphyrin Ether; C053434:Talaporfin