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Photodynamic Therapy Increases Survival in Stage IIIB NSCLC

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Combination of photodynamic therapy with standard chemotherapy and surgical resection may extend survival in patients with stage IIIB non-small cell lung cancer (NSCLC).

Lead investigator Joseph Friedberg, chief of thoracic surgery at Thomas Jefferson said the preliminary results from an ongoing phase II trial indicate that the treatment “adds a year to post surgery survival”.

20 patients ranging in age from 35 to 72 years were treated from December 1997 to February 2002.

Dr. Friedberg said the average post surgery cancer-free survival is 18 months, but a patient who was 37 when he underwent the procedure 4 years ago “remains cancer-free.”

Dr. Carr, colleague of Friedberg said that computed tomography (CT) of the brain and other organs were conducted at the time of diagnosis. “Patients were treated with standard chemotherapy,” he said. If chemotherapy failed, patients were referred to the study, at which time they were radiologically restaged to exclude patients with distant metastases.

Patients were injected with Photofrin 2 mg/kg 24 hours before surgery which then consisted of anatomic pulmonary resection (ranging from segmentectomy to pneumonectomy), mediastinal lymphadenectomy, parietal pleurectomy, and debulking, but not removal, of the diaphragm and pericardium.

Dr Carr said six light detectors were then sewn into the chest at strategic locations and 630 nm light was delivered to a measured dose of 30 J/cm2. The detectors were then removed and the chest closed.


One patient received preoperative radiation and 10 patients received postoperative mediastinal radiation. Follow-up consisted of quarterly visits and chest CT scans.

Overall median survival, calculated from surgery/photodynamic therapy (not diagnosis), for the 20 patients was 20 months, Dr. Carr said. Median survival to local recurrence was 18 months.

Photodynamic therapy appears “to enhance the immune system. Moreover, there is something about the way cancer cells are killed photodynamically that is particularly potent,” Dr Carr said.

(Source: Medscape)


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Dates

Posted On: 8 November, 2002
Modified On: 3 December, 2013

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