Photodynamic therapy for localised inoperable endobronchial cancer

Localised endobronchial (non-small-cell) lung cancer describes disease in which malignancy is confined within the bronchial wall, with no radiographic or endoscopic evidence of lymph node involvement. Patients for whom surgical resection may be considered unsuitable include those with bilateral lung cancer, impaired respiratory function because of chronic obstructive pulmonary disease or other conditions posing high operative risk, those who have had previous resection for lung cancer, and those who refuse surgery.

The range of treatment options for lung cancer depends on the type and stage of the disease and the suitability of major surgery for the individual patient. Treatment options include laser ablation, endobronchial brachytherapy and external-beam radiation.

Photodynamic therapy (PDT) involves injection of a photosensitising agent, followed a few days later by photoradiation of the affected area through a bronchoscope. This aims to reduce tumour bulk, so reducing symptoms caused by bronchial obstruction. Endobronchial debridement of necrotic tumour is required, commonly 48 hours after each treatment. The procedure can be repeated if necessary.