Author of

• 11946

  +

  P2.24 - Poster Session 2 - Supportive Care (ID 157)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11974

    +

    P2.24-028 - Photodynamic Therapy for Airway Malignancies: A 15-year single institution experience (ID 1701)

    09:30 - 09:30  |  Author(s): J. Wilson
    • Abstract

    Background
    Photodynamic therapy (PDT) is a unique combination of photosensitizing drug and laser light for drug activation which results in tissue destruction by direct cellular damage and small vessel thrombosis. We have utilized PDT to manage airway malignancies since 1998. This large, single institution case series will describe technical considerations of airway PDT,incorporation of PDT into multi modality therapy, patient selection, patient management and clinical outcomes.

    Methods
    All patients receiving PDT were entered into an IRB approved outcomes registry. Data was abstracted from the medical record and the cancer registry. Photofrin was used as the photosensitizer at a dose of 2 mg/kg IV . Light dosimetry ranged from 100 - 200 J. Light was delivered at 630 nm. All patients were treated under general anesthesia for light application and airway debridement. Autofluorescent bronchoscopy was used to delineate extent of endobronchial disease.

    Results
    Between 1998 and 2013, we have performed PDT on 910 patients; 519 procedures (57%) have involved the tracheobronchial tree. The average age was 62 years with a range of 18 -92 years.The cell types managed by PDT included NSCLC, SCLC, carcinoid, and metastases to the airway. Indications for tracheobronchial PDT included symptom management/ palliation (63%), induction therapy (27%), and definitive therapy with curative intent (10%). Dyspnea and post obstructive pneumonia from airway obstruction were the most common symptoms. Photosensitivity rate was < 2%. There were no perforations of the tracheobronchial tree. There was a single stricture in this cohort; this occurred in a patient who had been previously resected.

    Conclusion
    PDT for primary or metastatic lesions to the tracheobronchial tree is safe. Early and advanced lesions can be treated. PDT can be used prior to surgical resection and may increase resectability by reducing endoluminal disease. PDT may be used after radiation therapy with good efficacy. PDT can be utilized during multiple courses of treatment to palliate obstructing or bleeding lesions. Photosensitivity is an infrequent complication. Our experience demonstates the utility of PDT across all stages of NSCLC when there is a visible endoluminal component. In order to more specifically define the utility of PDT in NSCLC, we have established a prospective multi center registry to delineate indications, contraindications and the role of PDT in treatment algorhythms for airway malignancies.