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Y. Kudo
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P2.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 210)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.02-006 - Development of the New Photodynamic Therapy for Peripheral Type Lung Cancer (ID 2322)
09:30 - 17:00 | Author(s): Y. Kudo
- Abstract
Background:
In Japan, photodynamic therapy (PDT) has been recommended for the treatment of centrally located early lung cancers (CLELC). With recent advances in the diagnosis lung cancer, we continually attempt to expand the indications of PDT, not only for CLELC but also for peripheral type lung cancer. PDT for peripheral lung cancer could be one of the desirable treatment options for patients without surgical indication such as poor pulmonary function. To perform PDT for peripheral lung nodules, it is necessary to use a thin and flexible laser fiber that can sufficiently reach the peripheral lung parenchyma. In this study, we evaluated the feasibility and efficacy of a plastic laser fiber for peripheral PDT.
Methods:
A plastic fiber (cylindrical light diffuser Model RD [Medlight, Switzerland]) was used as a laser fiber for peripheral PDT. The laser output and the light irradiation distribution of the RD cylindrical light diffuser were measured and compared with those of the Panasonic cylindrical probe currently used for PDT. NPe6-PDT was performed for peripheral pig lung. One week after PDT, the pigs were dissected and the lung was removed. The efficacy of NPe6-PDT was evaluated by the pathological findings.
Results:
The mean difference in laser output and the laser source output was 17.7±1.6% for the Panasonic cylindrical fiber and 11.6±3.1% for the RD cylindrical light diffuser. For the light irradiation distribution, the RD cylindrical light diffuser was able to produce more uniform irradiation than the Panasonic cylindrical fiber. The pathological findings showed necrotic tissue and infiltration of lymphoid cells at the laser irradiation area. Around the necrotic tissue, thickening of the alveolar walls and obstruction of the vessels due to thickening of the vascular endothelium were observed.
Conclusion:
The cylindrical light diffuser Model RD showed comparable laser irradiation to the Panasonic cylindrical fiber. The animal experiment showed the effect of PDT in peripheral lung. We conclude that PDT for peripheral lung using the new fiber is feasible and could become one treatment option for peripheral lung cancer.
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P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.03-035 - Impact of Lymph Node Involvement on Survival in Patients with Completely Resected Pulmonary Squamous Cell Carcinoma (ID 1301)
09:30 - 17:00 | Author(s): Y. Kudo
- Abstract
Background:
Lymph node involvement is an important prognostic factor in non-small cell lung cancer (NSCLC) patients. However, the prognostic impact varies among the histological types of NSCLC because of the lymph node spread pattern or other factors. We re-evaluated the impact of lymph node involvement and other clinicopathologic factors on survival in patients with pulmonary squamous cell carcinoma (SqCC) and identified high-risk patients who may benefit from additional therapy.
Methods:
Between 1990 and 2010, 530 consecutive T1-4N0-2M0 SqCC patients underwent complete resection with systematic lymph node dissection at our hospital. We statistically analyzed the association between lymph node involvement and clinicopathologic factors, as well as clinical outcomes.
Results:
The 5-year overall survival (5y-OS) rates of the patients with stages I, II, and III were 66.5%, 57.6%, and 30.0%, respectively (stage I vs stage II, NS). Multivariate survival analysis showed that patients with N2 had significant associations with unfavorable prognosis (HR = 2.58, p < 0.0001). The 5y-OS rate for N2 tumors (32.1%) was significantly worse than those for N0 and N1 tumors (63.0% and 56.6%, respectively). In stages I and II, tumor size > 5 cm, pleural invasion (PL), and age over 70 years were found to be significant independent prognostic factors by multivariate survival analysis, but lymph node status (N0 or N1) was not. Thus, tumors ≤ 5 cm without PL and tumors ≤ 3 cm with PL were classified as the new stage I (5y-OS, 69.8%) in the patients with N0 or N1, and tumors > 5 cm without PL and tumors > 3 cm with PL were classified as the new stage II (5y-OS, 45.7%). In contrast, tumors with N2 were classified as the new stage III (5y-OS, 32.1%). There was a statistically significant difference among these groups.
Conclusion:
N2 status was strongly associated with poor outcome in SqCC patients, but not N1 status. Our results indicate that lymph node status should not be incorporated into the staging system for N0-1 SqCC patients This information might prompt the design of clinical trials on additional therapy for these patients. Figure 1
