Journal of Clinical Oncology, Vol 22, No 11 (June 1), 2004: pp. 2192-2201
© 2004 American Society of Clinical Oncology.
DOI: 10.1200/JCO.2004.07.097
Phase II Trial of Pleural Photodynamic Therapy and Surgery for Patients With NonSmall-Cell Lung Cancer With Pleural Spread
Joseph S. Friedberg,
Rosemarie Mick,
James P. Stevenson,
Timothy Zhu,
Theresa M. Busch,
Daniel Shin,
Debbie Smith,
Melissa Culligan,
Andreea Dimofte,
Eli Glatstein,
Stephen M. Hahn
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: Nonsmall-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]
|
 |
|
|