Background: Patients with centrally located early lung cancer (CLELC) are often heavy smokers with a considerably high risk of multiple lung cancer (MPLC) lesions; treatment strategies for such patients must preserve the cardiopulmonary function.
Methods: Between June 2013 and June 2018, 10 patients with CLELC underwent photodynamic therapy (PDT) using NPe6, second-generation photosensitizer at Nippon Medical School Hospital. Among these patients, we retrospectively analyzed MPLC which were treated by surgery plus PDT or PDT alone, and examined the effectiveness of PDT and we propose a treatment strategy for patients with MPLC.
Results: Eight patients underwent surgery (five lobectomies and three partial resections) for primary lung cancer and then underwent NPe6-PDT for the treatment of secondary primary CLELC, two patients were performed PDT alone.
In 6 of these 10 patients, CLELC was found as metachronous lesions and in 4 patients as synchronous lesions using sputum cytology and a bronchoscopical examination using autofluorescence bronchoscopy.
All 10 lesions were CLELC and identified by autofluorescence bronchoscopy. Among the 10 patients with MPLC including peripheral-type lung cancers which were resected by surgery, all 10 CLELC lesions exhibited a complete response after PDT.
Conclusions: For lung cancer patients with a long-term history of smoking, careful follow-up examinations after surgical resection are needed considering the incidence of metachronous primary lung cancers. PDT can play an important role for the treatment strategy for MPLC.
Background: Skin photosensitivity is a major side effect of photodynamic therapy (PDT). It is induced by the photosensitizer remaining in the skin. It is usually rapidly metabolized by the liver, but the pharmacokinetic profile varies widely among individuals. This makes it difficult to predict the incidence of skin photosensitivity. Therefore, we conducted a prospective study to investigate whether the NPe6 fluorescence intensity in skin after NPe6-PDT could be measured safely in human patients using a fluorescence sensing system for judging the risk of skin photosensitivity.
Methods: The NPe6 fluorescence measurements using a constructed fluorescence sensing system at the inside of the arm were acquired prior to and 5 and 10 minutes after NPe6 administration as well as at the time of PDT (4-5 hours after administration), at discharge (2 or 3 days after PDT), and at 1 or 2 weeks after PDT. Participants were interviewed as to whether they had any complications at 2 weeks after PDT.
Results: Nine male patients and one female patient entered this study. All of the measurements of NPe6 fluorescence in the skin could be obtained without any complications. The spectral peak was detected at the time of discharge (2-3 days after administration) in most cases and it decreased at 1 or 2 weeks after PDT.
Conclusions: The fluorescence of NPe6 in the skin could be detected feasibly using the fluorescence sensing system in human patients. Measuring fluorescence intensity in the skin might be useful to predict the incidence of skin photosensitivity after PDT.
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