[Endoscopic treatment of lung cancer]

There are many kinds of endoscopic treatment for lung cancer. In this paper the authors describe these methods and present representative cases. The first is laser treatment. There are three methods of endoscopic laser treatment. One is vaporization using high-power lasers, for example, the Nd-YAG laser. Indications for high-power laser treatment include obstructive lesions of the trachea or large bronchi with no recognizable peripheral focus. The second is photodynamic therapy (PDT) using tumor-specific photosensitizers, and low-power lasers. PDT has potential for the treatment of early stage lung cancer. The third is "laser chemotherapy," which is a new method developed by the authors using low-power lasers, e.g., He-Ne lasers, combined with chemotherapy. It is possible that antitumor drugs could be administered in doses lower than used at present. The second method is bronchofiberscopic ethanol injection therapy for stenosis or obstruction of central airways in order to obtain airway dilatation or hemostasis. The third method is brachytherapy or endobronchial radiation for central type lung cancer. We use a bronchofiberscope to place the applicator into the target bronchial lumen. Radiation therapy is performed with 60Co high dose-rate endobronchial radiation by a remote after-loading system. The value of laser treatment has been amply demonstrated and the other methods are also yielding encouraging results in the treatment of lung cancer.