Definitive surgery and intraoperative photodynamic therapy for locally advanced non-small cell lung cancer: a case report

Abstract Background There are no guidelines for straightforwardly managing advanced lung cancer (T3 or T4). Although surgery has traditionally been regarded as the mainstay treatment and the only curative modality, it has limited relevance for patients with locally advanced non-small cell lung cance...

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Main Authors: Hee Suk Jung, Hyun Jung Kim
Format: Article
Language:English
Published: BMC 2022-08-01
Series:World Journal of Surgical Oncology
Subjects:
Online Access:https://doi.org/10.1186/s12957-022-02729-5
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author Hee Suk Jung
Hyun Jung Kim
author_facet Hee Suk Jung
Hyun Jung Kim
author_sort Hee Suk Jung
collection DOAJ
description Abstract Background There are no guidelines for straightforwardly managing advanced lung cancer (T3 or T4). Although surgery has traditionally been regarded as the mainstay treatment and the only curative modality, it has limited relevance for patients with locally advanced non-small cell lung cancer (NSCLC). Photodynamic therapy (PDT) is a clinically approved cancer therapy; it is an established treatment modality with curative intent for early-stage and superficial endobronchial lesions. However, the efficacy of PDT in advanced lung cancer is controversial, and it has primarily been used in palliative care. Case presentation This case report describes a 70-year-old male who had right upper lung cancer and an endobronchial lesion that extended into the distal trachea. A biopsy specimen was obtained upon bronchoscopy, and the result confirmed squamous cell carcinoma. We performed a definitive sleeve lobectomy and intraoperative PDT. Gross total resection of the tumor was achieved, but the presence of microscopic residual tumors was inevitable. Complete anatomical resection of the primary tumor by pneumonectomy was not possible due to poor lung function and endobronchial extension to the distal trachea. We decided to apply intraoperative PDT to the lumen and outer wall of the bronchi and distal trachea for local tumor control. The patient is alive with no evidence of disease after 13 months of follow-up. Conclusions This is the first report to describe the feasibility and efficacy of intraoperative PDT as part of multimodal therapy for locally advanced NSCLC.
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spelling doaj.art-6e0b065e477645c5826343d836bfd2032022-12-22T02:16:00ZengBMCWorld Journal of Surgical Oncology1477-78192022-08-012011510.1186/s12957-022-02729-5Definitive surgery and intraoperative photodynamic therapy for locally advanced non-small cell lung cancer: a case reportHee Suk Jung0Hyun Jung Kim1Department of Thoracic and Cardiovascular Surgery, CHA Bundang Medical Center, CHA UniversityDepartment of Thoracic and Cardiovascular Surgery, CHA Bundang Medical Center, CHA UniversityAbstract Background There are no guidelines for straightforwardly managing advanced lung cancer (T3 or T4). Although surgery has traditionally been regarded as the mainstay treatment and the only curative modality, it has limited relevance for patients with locally advanced non-small cell lung cancer (NSCLC). Photodynamic therapy (PDT) is a clinically approved cancer therapy; it is an established treatment modality with curative intent for early-stage and superficial endobronchial lesions. However, the efficacy of PDT in advanced lung cancer is controversial, and it has primarily been used in palliative care. Case presentation This case report describes a 70-year-old male who had right upper lung cancer and an endobronchial lesion that extended into the distal trachea. A biopsy specimen was obtained upon bronchoscopy, and the result confirmed squamous cell carcinoma. We performed a definitive sleeve lobectomy and intraoperative PDT. Gross total resection of the tumor was achieved, but the presence of microscopic residual tumors was inevitable. Complete anatomical resection of the primary tumor by pneumonectomy was not possible due to poor lung function and endobronchial extension to the distal trachea. We decided to apply intraoperative PDT to the lumen and outer wall of the bronchi and distal trachea for local tumor control. The patient is alive with no evidence of disease after 13 months of follow-up. Conclusions This is the first report to describe the feasibility and efficacy of intraoperative PDT as part of multimodal therapy for locally advanced NSCLC.https://doi.org/10.1186/s12957-022-02729-5Non-small cell lung carcinomaSurgical proceduresPhotochemotherapy
spellingShingle Hee Suk Jung
Hyun Jung Kim
Definitive surgery and intraoperative photodynamic therapy for locally advanced non-small cell lung cancer: a case report
World Journal of Surgical Oncology
Non-small cell lung carcinoma
Surgical procedures
Photochemotherapy
title Definitive surgery and intraoperative photodynamic therapy for locally advanced non-small cell lung cancer: a case report
title_full Definitive surgery and intraoperative photodynamic therapy for locally advanced non-small cell lung cancer: a case report
title_fullStr Definitive surgery and intraoperative photodynamic therapy for locally advanced non-small cell lung cancer: a case report
title_full_unstemmed Definitive surgery and intraoperative photodynamic therapy for locally advanced non-small cell lung cancer: a case report
title_short Definitive surgery and intraoperative photodynamic therapy for locally advanced non-small cell lung cancer: a case report
title_sort definitive surgery and intraoperative photodynamic therapy for locally advanced non small cell lung cancer a case report
topic Non-small cell lung carcinoma
Surgical procedures
Photochemotherapy
url https://doi.org/10.1186/s12957-022-02729-5
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