Photodynamic therapy for multiple primary metachronous central lung cancer in inoperable patient. Case report

Aim: to estimate the effectiveness of photodynamic therapy (PDT) in treatment for multiple primary central lung cancer (case study). From 2001 till 2013 in the thoracic oncology department of Chelyabinsk district clinical oncologic dispensary we were observing patient M., born in the year of 1947, who had central multiple primary metachronous cancer of right and left lungs. The tumor in the right lung was subjected to chemoradiation in 2001-2002. This led to long-lasting remission. In 2011 we diagnosed central non-small-cell cancer of left lung distal bronchus. Considering the background pathology the conventional antineoplastic therapy was contraindicated. From April 2011 to June 2013 the left lung distal bronchus tumor was subjected to 18 sessions of photodynamic therapy (an average 1 session per 1.5 months). PDT was performed using the 662-nm-wave laser by introducing a flexible single-fiber quartz lightguide via biopsy channel of fiber-optic bronchoscope in 2.5-3 hours after administration of photosensitizer Photolon or Radachlorin. The performed PDT resulted in good palliative effect due to decreased cough and dyspnea. Endoscopic view showed decrease in the left distal bronchus tumor and improved bronchus patency. Thus, we may state that PDT is effective enough in treatment for multiple primary metachronous malignant central lung tumors at early stages when conventional antineoplastic measures are contraindicated. The method is not associated with considerable technical difficulties, has significant symptomatic efficiency and is safe.