Author of

• 20039

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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

  • 19848

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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): H.J. Mehta
    • 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

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    Patient #	Age	Sex	Operation	Histology	Type of residual disease	Site of treatment	Pattern of recurrence	PFS months	Overall survival months	Alive
    1	53	M	Lobectomy	Adeno ca	MRD	LLL	regional	49	66	Y
    2	80	F	Lobectomy	SCCa	CIS	LUL	n/a	n/a	45	N
    3	80	F	Segmentectomy	Adeno ca	MRD	RML	Distant	10	11	N
    4	57	M	Lobectomy	SCCa	CIS	RLL	n/a	n/a	70	Y
    5	66	M	Lobectomy	SCCa	MRD	LLL	Distant	28	32	N
    6	40	M	Lobectomy	Adeno ca	MRD	RUL	regional	36	59	N
    7	66	F	Lobectomy	Adeno ca	MRD	RLL	n/a	n/a	86	Y
    8	67	F	Lobectomy	SCCa	MRD	RML	Distant	26	34	N
    9	76	M	Sleeve lobectomy	SCCa	MRD	LLL	n/a	n/a	39	N
    10	72	F	Segmentectomy	SCCa	CIS	RUL	Local	24	73	Y
    11	74	F	Lobectomy	SCCa	MRD	LUL	Distant	21	25	N

    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.