This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Friedberg, J. S. Articles by Hahn, S. M. Search for Related Content PubMed PubMed Citation Articles by Friedberg, J. S. Articles by Hahn, S. M. Social Bookmarking                            What's this?

Phase II Trial of Pleural Photodynamic Therapy and Surgery for Patients With Non–Small-Cell Lung Cancer With Pleural Spread

From the Department of Surgery, Thomas Jefferson University Hospital; and the Departments of Biostatistics and Epidemiology, Medicine, and Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA

Address reprint requests to Stephen M. Hahn, MD, 3400 Spruce St, 2 Donner, Philadelphia, PA 19104-4283; e-mail: hahn{at}xrt.upenn.edu

PURPOSE: Non—small-cell lung cancer (NSCLC) with pleural spread is incurable, with median survival rates ranging from 6 to 9 months. Surgery alone fails to locally control this disease or extend survival beyond the accepted treatment, palliative chemotherapy.

METHODS: We conducted a phase II trial to evaluate the effects on local control and survival of combining surgery with intraoperative photodynamic therapy (PDT), a light-based cancer treatment, in patients with NSCLC with pleural spread. Patients received porfimer sodium (2 mg/kg), 24 hours before surgery, at which time all gross tumor was resected and followed by illumination of the hemithorax with 630 nm light to a measured dose of 30 J/cm². Photosensitizer levels in tumor and surrounding normal tissue were measured.

RESULTS: Twenty-two patients with NSCLC were enrolled; 17 underwent complete debulking and PDT, three underwent partial debulking/PDT, and two patients were unresectable. Local control of pleural disease at 6 months was achieved in 11 of 15 (73.3%; 95% CI, 44.9% to 92.2%) assessable patients. Median overall survival for all 22 patients was 21.7 months (95% CI, 17.7 to 25.8 months). Measured levels of porfimer sodium in tumor were greater than those measured in normal tissues, with ratios ranging from 1.19 to 22.42.

CONCLUSION: Our results indicate surgery and PDT can be performed safely with very good local control. The median survival of 21.7 months, calculated from the time of surgery and PDT is encouraging. Further evaluation of this therapy is warranted.

Supported in part by National Institutes of Health grant PO1 CA 87971.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				A. Lin and S. M. Hahn Photodynamic Therapy: A Light in the Darkness? Clin. Cancer Res., July 1, 2009; 15(13): 4252 - 4253. [Abstract] [Full Text] [PDF]

				E. Kabingu, A. R. Oseroff, G. E. Wilding, and S. O. Gollnick Enhanced Systemic Immune Reactivity to a Basal Cell Carcinoma Associated Antigen Following Photodynamic Therapy Clin. Cancer Res., July 1, 2009; 15(13): 4460 - 4466. [Abstract] [Full Text] [PDF]

				K. Konopka and T. Goslinski Photodynamic Therapy in Dentistry Journal of Dental Research, August 1, 2007; 86(8): 694 - 707. [Abstract] [Full Text] [PDF]

				S. M. Hahn, M. E. Putt, J. Metz, D. B. Shin, E. Rickter, C. Menon, D. Smith, E. Glatstein, D. L. Fraker, and T. M. Busch Photofrin uptake in the tumor and normal tissues of patients receiving intraperitoneal photodynamic therapy. Clin. Cancer Res., September 15, 2006; 12(18): 5464 - 5470. [Abstract] [Full Text] [PDF]

				S. M. Hahn, D. L. Fraker, R. Mick, J. Metz, T. M. Busch, D. Smith, T. Zhu, C. Rodriguez, A. Dimofte, F. Spitz, et al. A Phase II Trial of Intraperitoneal Photodynamic Therapy for Patients with Peritoneal Carcinomatosis and Sarcomatosis Clin. Cancer Res., April 15, 2006; 12(8): 2517 - 2525. [Abstract] [Full Text] [PDF]

				K. A. Cengel, S. M. Hahn, and E. Glatstein C225 and PDT Combination Therapy for Ovarian Cancer: The Play's the Thing J Natl Cancer Inst, October 19, 2005; 97(20): 1488 - 1489. [Full Text] [PDF]

				V. Patel and J. B. Shrager Which Patients with Stage III Non-Small Cell Lung Cancer Should Undergo Surgical Resection? Oncologist, May 1, 2005; 10(5): 335 - 344. [Abstract] [Full Text] [PDF]