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Running Head: PDT
Photodynamic Therapy in the Treatment of Lung Cancer
(Your Name Goes Here)
Great Neck South High School
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Photodynamic Therapy in the Treatment of Lung Cancer
Lung cancer is defined as the abnormal, uncontrollable growth of cells in the
lungs. It is currently a leading cause of death all around the world, being the top cancerrelated killer among males in over 25 industrialized countries, and the leading cause of
death from cancer among women in the United States. Rates of death from lung cancer
have gone up particularly since the end of World War II due to greatly increased cigarette
smoking (Lung Cancer, 2007). As numbers of diagnoses for the disease have gone up, so
has the endless amount of research being done to find a cure, or at least an effective
treatment. Among the forefront of emerging forms of preferred treatment today is a
relatively new technique called photodynamic therapy (PDT). Several medical centers
across the globe have conducted tests with this method of treatment, and there have been
relatively high response rates (Mathur, Edell, Sutedja, & Vergnon, 2003).
PDT is a unique method of treatment that involves the use of two key elements: a
special type of light (often either a laser or a light-emitting diode) and a particular drug,
called a photosensitizing agent. When applied to lung cancer treatment, PDT is a 2-phase
process. The tissue surrounding the tumor is treated first with the photosensitizing agent
either topically or through injection. The agent has the ability to selectively accumulate in
the tumor tissue, or where there is a high concentration of abnormal cells over the course
of 24 to 72 hours. It is then exposed to a specific wavelength of light, resulting in the
production of a form of molecular oxygen that destroys neighboring cells (National
Cancer, 2007; Moghissi, 2004). Currently, the only photosensitizing agent that has been
approved by the U.S. Food and Drug Administration for use in PDT is a compound called
porfimer sodium, also known as Photofrin® (National Cancer Institute, 2007). The FDA
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has so far approved the use of PDT with Photofrin® for the treatment of a number of
cancers, including certain esophageal and skin cancers. The use of PDT in lung cancer
treatment is relatively new (Penn Today, 2005). From 1980 to 2003, 145 patients with
early-stage non-small-cell lung cancer (NSCLC) were treated with PDT (Mathur et al.,
2003). The first of these studies involved the use of bronchoscopic PDT in the early
1980s at Tokyo Medical University on a patient with a very early-stage case who refused
surgery. The tumor went into complete remission, and the patient survived for 4 years,
dying later from non-cancer-related causes (Moghissi, 2004). Since then, extensive
research has continued to be conducted in several medical facilities across the globe,
including at several centers in Japan and the United States, as well as additional smaller
studies in Europe and Canada. Recently published data by Corti et al. (2007) has yielded
promising results. Over the course of 15 years from June 1989 to November 2004, 40
patients with recurrent NSCLC were treated with PDT and observed. The results showed
a 72% complete remission rate, where no microscopically evident vestiges of the tumor
remained. The subsequent mean 5-year overall survival (OS) rate was 59.55%. In
addition, Furukawa et al. (2005) have offered similarly promising results in a study
where 93 patients with lung cancer tumors underwent PDT treatments from 1980 to 2001.
The study produced 5-year survival rates of 57.9% among patients with tumors less than
1.0 cm in diameter and 59.3% in patients with tumors greater than 1.0 cm in diameter.
Furthermore, the complete remission rate in patients with tumors less than 1.0 cm in
diameter was 92.8%, a remarkable number. All these figures compare very favorably
with results of common surgical resection and chemotherapy procedures, which produce
around 60-70% 5-year survival rates among patients with early stage NSCLC, and 10-
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20% rates among patients with more advanced, unresectable cases (Collins et al., 2007).
Moreover, Friedberg et al. (2004) detailed trials that combined PDT and surgery in
treating 22 enrolled lung cancer patients with pleural spread, which is when the cancerous
cells the outer lung membrane. Patients with pleural spread are considered incurable. The
results yielded a median survival rate of 21.7 months, compared with typical values of 6
to 9 months for similar patients treated with other non-operative methods. The results
from each of these studies reflect a significantly high effectiveness of PDT in extending
the lifetime of lung cancer patients.
Currently, primary treatments for most cases of lung cancer continue to lean
toward resection, chemotherapy and radiotherapy (Collins, Haines, Perkel, & Enck,
2007). However, the future of photodynamic therapy in treating lung cancer looks
promising. It is emerging as a primary choice for treatment for early-stage lung cancer
with tumors less than 1 cm in diameter, making it an attractive alternative in cases where
surgical resection is either unsuited for or refused by the patient (Corti et al., 2007).
However, the prospect for PDT is still highly uncertain. Though it is gaining ground, it is
still most often used as a side treatment in conjunction with other more common and
tested methods like chemotherapy or radiotherapy (Moghissi & Dixon, 2003). While
PDT is not yet at the stage of curing cancer, it will likely continue to increase in both
effectiveness and prevalence of use in the future as more research is accumulated.
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References
Collins, L. G., Haines, C., Perkel, R., & Enck, R. E. (2007). Lung Cancer: Diagnosis and
Management. American Family Physician, 75, 56-63.
Corti, L., Toniolo, L., Boso, C., Colaut, F., Fiore, D., Muzzio, P., Koukourakis, M. I.,
Mazzarotto, R., Pignataro, M., Loreggian, L., & Sotti, G. (2007). Long-Term
Survival of Patients Treated With Photodynamic Therapy for Carcinoma In Situ
and Early Non-Small-Cell Lung Carcinoma. Lasers in Surgery and Medicine, 39,
394-402.
Furukawa, K., Kata, H., Konaka, C., Okunaka, T., Usuda, J., & Ebihara, Y. (2005).
Locally Recurrent Central-Type Early Stage Lung Cancer < 1.0 cm in Diameter
After Complete Remission by Photodynamic Therapy. Chest, 128, 3269-3275.
Friedberg, J. S., Mick, r., Stevenson, J. P., Zhu, T., Busch, T. M. Shin, D., Smith, D.,
Culligan, M., Dimofte, A., Glatstein, E., & Hahn, S. (2004). Phase II Trial of
Pleural Photodynamic Therapy and Surgery for Patients With Non-Small-Cell
Lung Cancer With Pleural Spread. Journal of Clinical Oncology, 22, 2192-2201.
Lung cancer. (2007). In Encyclopedia Britannica. Retrieved September 20, 2007, from
Encyclopedia Britannica Online: http://search.eb.com/eb/article-214265.
Mathur, P. N., Edell, E., Sutedja, T., & Vergnon, J. (2003). Treatment of Early Stage
Non-Small Cell Lung Cancer. Chest, 123, 176-180.
Moghissi, K. (2004). Role of Bronchoscopic Photodynamic Therapy in Lung Cancer
Management. Current Opinion in Pulmonary Medicine, 10, 256-260
Moghissi, K., & Dixon, K. (2003). Is bronchoscopic photodynamic therapy a therapeutic
option in lung cancer? European Respiratory Journal, 22, 535-541.
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Photodynamic Therapy for Cancer: Questions and Answers. (2007). Retrieved October
16, 2007, from http://www.cancer.gov/cancertopics/
factsheet/Therapy/photodynamic.
Photodynamic Therapy Improves Lung Cancer Survival Rates. (2005). Retrieved October
29, 2007 from http://pennhealth.com/phys_forum/ pto/jan_feb05/photo.html.