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. 1997 Mar;52(3):281–283. doi: 10.1136/thx.52.3.281

Endoscopic laser therapy in malignant tracheobronchial obstruction using sequential Nd YAG laser and photodynamic therapy

K Moghissi, K Dixon, E Hudson, M Stringer, S Brown
PMCID: PMC1758524  PMID: 9093347

Abstract

BACKGROUND: Because the survival after treatment of advanced inoperable endo-tracheobronchial carcinoma is so poor, a pilot study was undertaken to evaluate the combined cumulative effect on survival of neodymium yttrium aluminium garnet (Nd YAG) laser followed by photodynamic treatment used endoscopically. METHODS: Seventeen patients who presented between January 1992 and March 1996 with inoperable tracheobronchial lesions causing more than 50% endoluminal obstruction were selected to enter the pilot study. Initially they had bronchoscopic Nd YAG laser treatment to debulk the tumour, and this was followed six weeks later by photodynamic therapy to treat the residual tumour. RESULTS: All patients had symptomatic relief and at least a partial response, and seven had a complete response for 3-6 months. Eight of the 17 (47%) survived for at least two years and 11 (65%) survived for a year or more. The median survival of the 10 patients who had died by the time of writing was 18.5 months (range 5-39), 95% confidence interval (CI) 9.9 to 29.5. CONCLUSIONS: Combined Nd YAG laser and endoscopic photodynamic therapy may be an effective palliative treatment for patients with inoperable endotracheobronchial cancer. 




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Selected References

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  1. Balchum O. J., Doiron D. R., Huth G. C. Photoradiation therapy of endobronchial lung cancers employing the photodynamic action of hematoporphyrin derivative. Lasers Surg Med. 1984;4(1):13–30. doi: 10.1002/lsm.1900040104. [DOI] [PubMed] [Google Scholar]
  2. Cavaliere S., Foccoli P., Farina P. L. Nd:YAG laser bronchoscopy. A five-year experience with 1,396 applications in 1,000 patients. Chest. 1988 Jul;94(1):15–21. doi: 10.1378/chest.94.1.15. [DOI] [PubMed] [Google Scholar]
  3. Dumon J. F., Reboud E., Garbe L., Aucomte F., Meric B. Treatment of tracheobronchial lesions by laser photoresection. Chest. 1982 Mar;81(3):278–284. doi: 10.1378/chest.81.3.278. [DOI] [PubMed] [Google Scholar]
  4. Hayata Y., Kato H., Konaka C., Amemiya R., Ono J., Ogawa I., Kinoshita K., Sakai H., Takahashi H. Photoradiation therapy with hematoporphyrin derivative in early and stage 1 lung cancer. Chest. 1984 Aug;86(2):169–177. doi: 10.1378/chest.86.2.169. [DOI] [PubMed] [Google Scholar]
  5. Hetzel M. R., Smith S. G. Endoscopic palliation of tracheobronchial malignancies. Thorax. 1991 May;46(5):325–333. doi: 10.1136/thx.46.5.325. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. McCaughan J. S., Jr, Hawley P. C., Bethel B. H., Walker J. Photodynamic therapy of endobronchial malignancies. Cancer. 1988 Aug 15;62(4):691–701. doi: 10.1002/1097-0142(19880815)62:4<691::aid-cncr2820620408>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  7. Moghissi K., Jessop T., Dench M. A new bronchoscopy set for laser therapy. Thorax. 1986 Jun;41(6):485–486. doi: 10.1136/thx.41.6.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Personne C., Colchen A., Leroy M., Vourc'h G., Toty L. Indications and technique for endoscopic laser resections in bronchology. A critical analysis based upon 2,284 resections. J Thorac Cardiovasc Surg. 1986 May;91(5):710–715. [PubMed] [Google Scholar]
  9. Sabanathan S., Richardson J., Mearns A. J., Goulden C. Results of surgical treatment of stage III lung cancer. Eur J Cardiothorac Surg. 1994;8(4):183–187. doi: 10.1016/1010-7940(94)90112-0. [DOI] [PubMed] [Google Scholar]
  10. Toty L., Personne C., Colchen A., Vourc'h G. Bronchoscopic management of tracheal lesions using the neodynium yttrium aluminium garnet laser. Thorax. 1981 Mar;36(3):175–178. doi: 10.1136/thx.36.3.175. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Unger M. Bronchoscopic utilization of the Nd:YAG laser for obstructing lesions of the trachea and bronchi. Surg Clin North Am. 1984 Oct;64(5):931–938. doi: 10.1016/s0039-6109(16)43435-3. [DOI] [PubMed] [Google Scholar]
  12. Vincent R., Dougherty T., Rao U., Boyle D., Potter W. Photoradiation therapy in the treatment of advanced carcinoma of the trachea and bronchus. Prog Clin Biol Res. 1984;170:759–766. [PubMed] [Google Scholar]

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