Abstract
A prospective randomized study was set up to evaluate the efficacy of photodynamic therapy (PDT) compared with Neodymium Yttrium Aluminium Garnet (Nd-YAG) laser used endoscopically in patients with stage III inoperable lung cancer and substantial (>50%) endobronchial luminal obstruction: of the 26 patients in the study 11 were allocated to Nd-YAG laser treatment (Group I) and 15 to PDT (Group II). Patients were assessed clinically, radiologically, functinally and endoscopically before and at 1 monthly intervals after treatment for 3 months, then 3 monthly when applicable.
Age, sex, pulmonary function and mean percentage of bronchial luminal opening before treatment were comparable in the two groups, and not statistically different.
At 1 month after treatment all patients had subjective amelioration of their symptoms and objectively responded to treatment by a substantial increase in bronchial luminal opening. There was however a significantly greater improvement in the PDT (Group II) than the Nd-YAG laser treatment Group I (p<0.0006). The bronchial disobliteration was attended by improvement in pulmonary function which again was significantly greater in Group II (PDT) than in Group I (Nd-YAG).
It was concluded that endoscopic PDT in patients with extensive lung cancer and major airway obstruction is more effective than Nd-YAG laser treatment.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Toty L, Personne C, Colchen A, Vourc'h. Bronchoscopic management of tracheal lesions using the Nd-YAG laser.Thorax 1981,36;175–8
Dumon JF, Reboud E, Garbe L et al. Treatment of tracheo-bronchial tumours by laser photoresection.Chest 1982,81:278–84
Unger M. Neodymium YAG laser therapy for malignant and benign endobronchial obstructions. In: Unger M (ed)Clinics in Chest Medicine Symposium on Laser Techniques. Philadelphia: WB Saunders 1985,6:277–90
Hetzel MR, Smith SGT. Endoscopic palliation of tracheo-bronchial malignancies.Thorax 1991,46:325–33
Hayata Y, Kato H, Kinaka C et al. Haematoporphyrin derivative and photoradiation therapy in early stage lung cancer. In: Berns MW (ed)Haematoporphrin Derivative Photoradiation Therapy of Cancer. New York: Alan R Liss, 1984:39–47
Karnofsky DA, Burchenal JH. The clinical evaluation of chemotherapeutic agents in cancer. In: McLeod CM (ed)Evaluation of Chemotherapeutic Agents in Cancer. New York: Columbia University Press, 1949:191–205
Moghissi K, Jessop T, Dench M. A new bronchoscopy set for laser therapy.Thorax 1986,41:485–6.
Moghissi K, Parsons RJ, Dixon K. Photodynamic therapy (PDT) for bronchial carcinoma with the use of rigid bronchoscope.Lasers Med Sci 1991,7:381–5
Rosner BA.Fundamentals of Biostatics. Boston: Duxbury Press, 1982:417
Rosner BA.Fundamentals of Biostatics. Boston: Duxbury Press, 1982:435
Siegel S.Non-parametric Statistics for the Behavioral Sciences, New York: McGraw-Hill, 1956:184
Vincent R, Dougherty T. Photoradiation therapy in the treatment of advanced carcinoma of the trachea and brochus.Pro Clin Biol Res 1984,170:759–66
Balchum OJ, Doiron DR, Hutch GC. Photoradiation therapy of endobrochial lung cancer employing the photodynamic action of haematopophyrin derivative.Lasers Surg Med 1984, 4:13–30.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Moghissi, K., Dixon, K. & Parson, R.J. A controlled trial of Nd-YAG laser vs photodynamic therapy for advanced malignant bronchial obstruction. Laser Med Sci 8, 269–273 (1993). https://doi.org/10.1007/BF02547850
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02547850