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A. Khokar



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    Poster Display Session (ID 63)

    • Event: ELCC 2017
    • Type: Poster Display Session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 5/07/2017, 12:30 - 13:00, Hall 1
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      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. Khokar

      • Abstract

      Background:
      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.

      Methods:
      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.

      Results:
      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

      rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn rnrn
      Patient #AgeSexOperationHistologyType of residual diseaseSite of treatmentPattern of recurrencePFS monthsOverall survival monthsAlive
      153MLobectomyAdeno caMRDLLLregional4966Y
      280FLobectomySCCaCISLULn/an/a45N
      380FSegmentectomyAdeno caMRDRMLDistant1011N
      457MLobectomySCCaCISRLLn/an/a70Y
      566MLobectomySCCaMRDLLLDistant2832N
      640MLobectomyAdeno caMRDRULregional3659N
      766FLobectomyAdeno caMRDRLLn/an/a86Y
      867FLobectomySCCaMRDRMLDistant2634N
      976MSleeve lobectomySCCaMRDLLLn/an/a39N
      1072FSegmentectomySCCaCISRULLocal2473Y
      1174FLobectomySCCaMRDLULDistant2125N
      rn

      Conclusions:
      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

      Funding:
      None

      Disclosure:
      All authors have declared no conflicts of interest.