Intracavitary photodynamic therapy for malignant pleural mesothelioma

A total of 31 patients with malignant pleural mesothelioma disease, limited to one hemithorax, were entered into a phase II study of surgery and intracavitary photodynamic therapy. Photofrin, 2 mg/kg, was injected intravenously, and 48 hours later the patient was taken to the operating room. Bulk tumor was excised by a pleuropneumonectomy or pleurectomy. The patient then received 20-25 J/cm2 of 630 nm light energy from an argon dye laser. The overall estimated median survival of patients of all stages was 12 months. Survival of stage III and stage IV patients was 8 months. The median survival of 9 patients with stage I and II disease was 21 months. We plan to continue this clinical trial; however, entry will be limited to patients with stage I and II disease. The light dose for photodynamic therapy will be carefully increased to find the maximal tolerated dose.