[Photodynamic therapy for multiple primary lung cancer]

In recent years, multiple primary lung cancers have been reported with greater frequency, partly as a result of technologic advances in the detection of lung cancer and therapeutic achievements in its management. As for the treatment of multiple primary lung cancer, operative excision is usually difficult for all lesions due to problems of pulmonary function. PDT is a good therapeutic modality in the treatment of multiple primary lung cancer, especially central type lung cancer, for preservation of lung function. Since 1980, 27 patients of multiple primary lung cancers have been treated with PDT at Tokyo Medical College. Fourteen of these 27 patients were synchronous with the rest, metachronous. Seven of 27 patients with multiple tumors had early-stage lesions and were treated with endoscopic PDT alone. In other 20 cases, PDT was used to treat accessible early-stage foci although operative excision was required for advanced lesions. Mean survival after PDT, alone or in combination with surgery, was 52 months (range, 5 to 162 months) and 16 patients remain alive to date. PDT is useful in extending the therapeutic options for, and improving the prognosis of patients with, multiple primary bronchogenic carcinomas.