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Poster Display Session (ID 63)
- Event: ELCC 2017
- Type: Poster Display Session
- Presentations: 1
- Coordinates: 5/07/2017, 12:30 - 13:00, Hall 1
77P - Bronchoscopic photodynamic therapy for treatment of microscopic residual disease post resection in non-small cell lung cancer (ID 257)
12:30 - 13:00 | Author(s): A. Biswas
The goal of lung cancer surgery is a complete tumor resection (R0 resection) with tumor-free resection margins. However, 4-5% of lung cancer resections have evidence of microscopic residual disease which is associated with worse prognosis as compared to complete resection. Definitive management for such patients is re-operation and resection of residual tumor. However, a significant percent of patients may not be able to tolerate another surgery and for those patient’s definitive management is not well studied. We treated these patients with stage I cancer and mucosal residual disease with bronchoscopic PDT (photoynamic therapy) and report our experience here.
We conducted a retrospective analysis of patients who underwent definitive surgery for early stage lung cancer. All patients with R1 resection, stage I disease with mucosal residual tumor and or carcinoma in situ along the stump site were treated with bronchoscopic photodynamic therapy and were studied. Patient characteristics, histology, type and site of surgery, pattern of recurrence, recurrence status, and survival data were evaluated. Adverse events were recorded.
A total of 11 patients (Table) with mucosal R1 resection were treated with PDT along the stump site between 2007 and 2013. The breakdown according to the pattern of residual disease was as follows: CIS in 3 and MRD in 8 patients. One patient (9%) had local recurrence 1 year after treatment and was treated with radiation along the stump site. Four patients (36%) had no evidence of recurrence to date after a median follow up of 4 years and other 6 patients had evidence of regional (16%) or distant (45%) and were treated appropriately for the same. Local control rate was 91%. The median overall survival and progression free survival in our cohort of patients were 45 and 26 months respectively. One patient developed pneumonia and one patient has evidence of photosensitivity reaction.rnTable: 77Prn
rnrnrn Patient #rn Agern Sexrn Operationrn Histologyrn Type of residual diseasern Site of treatmentrn Pattern of recurrencern PFS monthsrn Overall survival monthsrn Alivern rnrn 1rn 53rn Mrn Lobectomyrn Adeno carn MRDrn LLLrn regionalrn 49rn 66rn Yrn rnrn 2rn 80rn Frn Lobectomyrn SCCarn CISrn LULrn n/arn n/arn 45rn Nrn rnrn 3rn 80rn Frn Segmentectomyrn Adeno carn MRDrn RMLrn Distantrn 10rn 11rn Nrn rnrn 4rn 57rn Mrn Lobectomyrn SCCarn CISrn RLLrn n/arn n/arn 70rn Yrn rnrn 5rn 66rn Mrn Lobectomyrn SCCarn MRDrn LLLrn Distantrn 28rn 32rn Nrn rnrn 6rn 40rn Mrn Lobectomyrn Adeno carn MRDrn RULrn regionalrn 36rn 59rn Nrn rnrn 7rn 66rn Frn Lobectomyrn Adeno carn MRDrn RLLrn n/arn n/arn 86rn Yrn rnrn 8rn 67rn Frn Lobectomyrn SCCarn MRDrn RMLrn Distantrn 26rn 34rn Nrn rnrn 9rn 76rn Mrn Sleeve lobectomyrn SCCarn MRDrn LLLrn n/arn n/arn 39rn Nrn rnrn 10rn 72rn Frn Segmentectomyrn SCCarn CISrn RULrn Localrn 24rn 73rn Yrn rnrnrn 11rn 74rn Frn Lobectomyrn SCCarn MRDrn LULrn Distantrn 21rn 25rn Nrn
Conclusion: Bronchoscopic photodynamic therapy (PDT) is a nonthermal ablative technique that can be used to treat central airway disease in adults. In conclusion, based on our findings, PDT is a safe and effective alternative therapy for patients with mucosal residual disease post R1 resection. Although this was a retrospective evaluation with a small sample, our data suggest that selected NSCLC patients after R1 resection may benefit from bronchoscopic PDT.
Clinical trial identification:
This is not a clinical trial.
Legal entity responsible for the study:
University of Florida
All authors have declared no conflicts of interest.