PURPOSE: Carcinoids are uncommon tumors in the thorax. Standard of care has been surgical resection with good survival and control reported as high as 85-97% in series.1-3 Nonsurgical treatment is poorly defined. Case series using stereotactic radiation, brachytherapy, Transcutaneous photodynamic therapy (PDT) or radiofrequency ablation for non surgical patient with thoracic malignancies have supplied the proof of concept that local ablative technologies can be employed to treat peripheral lung lesions.4-7 We report treatment of 2 peripheral carcinoid tumors treated with PDT via an airway approach.
METHODS: 2 patients (1 male, 1 female) ages 49, 76 with biopsy proven carcinoid tumors were treated with PDT using porfimer sodium 1-2 mg/kg and 630 nm laser at 100-200 J/cm. Response was and will be determined with post treatment surveillance using bronchoscopy with biopsy at 4-6 weeks followed by CT scan every 3 months for the first year.
RESULTS: Complete data has been collected on 1 patient who had a CR, with 5 year post-PDT w/o evidence of recurrence. The other patient is 1 month out from treatment and to date is without significant complication or side effect from the treatment.
CONCLUSION: Peripheral endoscopic PDT was possible in these 2 patients and was without significant side effects. There was a satisfactory tumoricidal effect and a sustained response in one patient of greater than 5 years. These cases are a proof of concept that PDT can be safely delivered to the periphery and has a biologic effect.
CLINICAL IMPLICATIONS: We believe that this justifies PDT for further consideration as a treatment option in this setting, as part of a controlled study.
DISCLOSURE: Franklin McGuire, No Financial Disclosure Information; No Product/Research Disclosure Information