[Photodynamic therapy, laser therapy, brachytherapy, stents. Local control of lung cancer]

As only a small proportion of patients presenting with lung cancer can be cured, palliation has a very important place in their treatment. The local effects of lung cancer often entail substantial deterioration of the patient's quality of life. Recent advances in such techniques as laser treatment, brachytherapy, photodynamic therapy and prosthetic stents have enabled important improvements to be made in the control of lung cancer (both primary tumours and metastases). Laser treatment is mainly used to obtain bronchial patency rapidly, but needs to be followed up with other treatments. Photodynamic therapy is confined to the treatment of very small early cancers, but may be curative in such cases. Brachytherapy, the brief introduction of a source of radiation in the bronchi, may be effective both in endobronchial tumours, and in cases where there is compression due to a tumour outside the bronchi. The method can be used repeatedly, even in patients undergoing external beam radiation therapy. Finally, prosthetic stents are increasingly used to maintain bronchial patency, both in malignant and in certain non-malignant diseases. The achievement of optimal results often entails the use of a combination of the various methods, thus necessitating close cooperation between lung specialists, oncologists, radiologists, ENT surgeons and GPs.