Photodynamic therapy for R1 lung cancer resections
https://doi.org/10.24884/0042-4625-2019-178-1-21-24
Abstract
The objective was to evaluate the effectiveness of endobronchial photodynamic therapy (PDT) for preventing a non-small cell lung cancer (NSCLC) relapse after R1 resection with positive bronchial resection margins.
Material and methods. This study included 17 patients. The planned morphological diagnostics revealed the presence of tumor cell complexes at the bronchial resection margins in 5 (29 %) patients (cancer in situ – 2, invasive cancer – 3), in peribronchial tissues – in 5 (29 %) patients, in lymphatic vessels at the resection margins – in 7 (41 %) patients.
Results. All patients underwent one session of endobronchial PDT as an adjuvant treatment. No complications of PDT were noted. The five-year observation revealed a relapse at the bronchial stump area in 1 patient only (6 %). 16 (94 %) patients lived for 1 year, 12 (71 %) patients – for 5 years. Long-term results were significantly worse in patients with tumor complexes in lymphatic vessels at the bronchial resection margins (5-year survival rate – 29 %, p=0.04), with pN2 (0 %, p=0.01), lung adenocarcinoma (20 %, p=0.03).
Conclusion. The use of endobronchial PDT as an adjuvant treatment for patients with NSCLC after R1 resection with positive bronchial resection margins is simple, safe and characterized by good immediate and long-term results.
About the Authors
A. L. Akopov
Pavlov University
Russian Federation
Competing Interests: Corresponding author: Аndrei L. Akopov, Pavlov University, 6-8 L’va Tolstogo street, St. Petersburg, Russia, 197022.
Russian Federation
Competing Interests: Corresponding author: Аndrei L. Akopov, Pavlov University, 6-8 L’va Tolstogo street, St. Petersburg, Russia, 197022.
A. A. Rusanov
Pavlov University
Russian Federation
Russian Federation
Anatolii A. Rusanov
St. Petersburg
N. V. Kazakov
Pavlov University
Russian Federation
Russian Federation
Nikita V. Kazakov
St. Petersburg
G. V. Papaian
Pavlov University
Russian Federation
Russian Federation
Garri V. Papaian
St. Petersburg
I. V. Chistiakov
Pavlov University
Ivan V. Chistiakov
St. Petersburg
References
1. Residual disease at the bronchial stump after curative resection for lung cancer / J. Wind, E. J. Smit, S. Senan, J. P. Eerenberg // Eur. J. Cardiothorac. Surg. 2007. № 32. Р. 29–34.
2. Riquet M., Achour K., Foucault C. et al. Microscopic residual disease after resection for lung cancer : a multifaceted but poor factor of prognosis // Ann. Thorac. Surg. 2010. Vol. 89, № 3. Р. 870–875.
3. Geun Dong, Lee Dong, Kwan Kim et al. Seung-Il Park Significance of R1-resection at the bronchial margin after surgery for non-small-cell lung cancer // Eur. J. of Cardio-Thoracic Surgery. 2017. Vol. 51, Is. 1. P. 176–181.
4. Snijder R. J., Brutel de la Riviere A., Elbers H. J. J. et al. Survival in resected stage I lung cancer with residual tumor at the bronchial resection margin // Ann. Thorac. Surg. 1998. № 65. Р. 212–216.
5. Mehmet Zeki Gunluoglu, Celalettin Ibrahim Kocaturk, Adalet Demir et al. Bronchial Stump Recurrence after Complete Resection of Lung Cancer : Effect of the Distance between the Tumor and Bronchial Resection Margin // Thorac. Cardiovasc. Surg. 2018. Vol. 66, № 2. Р. 156–163.
6. Ghiribelli C., Voltolini L., Paladini P. et al. Treatment and survival after lung resection for non-small cell lung cancer in patients with microscopic residual disease at the bronchial stump // Eur. J. Cardiothorac. Surg. 1999. № 16. Р. 555–559.
7. Griess D. F., McDonald J. R., Clagett O. T. The proximal extension of carcinoma of the lung in the bronchial wall // J. Thorac. Surg. 1945. № 14. Р. 362–368.
8. Meixiang Zhou, Tao Li, Yongmei Liu et al. Concurrent paclitaxel-based chemo-radiotherapy for post-surgical microscopic residual tumor at the bronchial margin (R1resection) in non-small-cell lung cancer // BMC Cancer. 2015. № 15. Р. 36.
9. Patterns of failure after postoperative radiotherapy for incompletely resected (R1) non-small cell lung cancer : Implications for radiation target volume design / M. Olszyna-Serementa, J. Socha, M. Wierzchowski, L. Kepka // Lung. Cancer. 2013. № 80. Р. 179–184.
10. Massard G., Doddoli C., Gasser B. et al. Prognostic implications of a positive bronchial resection margin // Eur. J. Cardiothorac. Surg. 2000. № 17. Р. 557–565.
11. Eric Vallières M. D., Paul Van Houtte M. D. et al. Carcinoma In Situ at the Bronchial Resection Margin // Journ. of Thoracic Oncology. 2011. P. 1617–1623.
12. Akopov A. L., Rusanov A. A., Papayan G. V. et al. Endobronchial photodynamic therapy under fluorescence control : potodynamic theranostics // Photodiagnosis and Photodynamic Therapy. 2017. Vol. 19. P. 73–77.
13. Akopov A. L., Chistyakov I. V., Rusanov A. A., Urtenova M. A., Dvoreckiy S. Y., Kazakov N. V., Gerasin A. V., Gorbunkov S. D., Agishev A. S., Ilyin A. A., Romanihin A. I. Reduction of resection volume in patients with non-small cell lung cancer after neoadjuvant chemoand photodynamic therapy. Vestnik khirurgii. 2017. Vol. 176, № 5, pp. 38–42. (In Russ.).
14. Akopov A. L., Rusanov A. A., Papayan G. V., Kazakov N. V., Gerasin A. V. Endobronchial photodynamic therapy under fluorescence control: potodynamic theranostics. Vestnik khirurgii. 2016. Vol. 175, № 5, pp. 26–31. (In Russ.).
15. Dohun Kim, Hong Kwan Kim, Yong Soo Choi et al. Central Lung Cancer Management : Impact of Bronchial Resection Margin Length // Thorac. Cardiovasc. Surg. 2015. Vol. 63, № 7. Р. 583–588.
16. Cotton R. E. The bronchial spread of lung cancer // Br. J. Dis. Chest. 1959. № 53. Р. 142–150.
17. Pasic A., Grunberg K., Mooi W. J. et al. The natural history of carcinoma in situ involving bronchial resection margins // Chest. 2005. № 128. Р. 1736–1741.
18. Owen R. M., Force S. D., Gal A. A. et al. Routine intraoperative frozen section analysis of bronchial margins is of limited utility in lung cancer resection // Ann. Thorac. Surg. 2013. Vol. 95, № 6. Р. 1859–1865.
19. Van Boxem A. J., Westerga J., Venmans B. J. et al. Photodynamic therapy, Nd-YAG laser and electrocautery for treating early-stage intraluminal cancer : which to choose? // Lung Cancer. 2001. № 31. Р. 31–36.
20. Photodynamic therapy (PDT) for lung cancer / R. Allison, K. Moghissi, G. Downie, K. Dixon // Photodiagnosis Photodyn Ther. 2011. № 8 (3). Р. 231–239.
21. Mehta H. J., Biswas A., Fernandez-Bussy S. et al. Photodynamic Therapy for Bronchial Microscopic Residual Disease After Resection in Lung Cancer // Journal of Bronchology & Interventional Pulmonology
Review
For citations:
Akopov A.L., Rusanov A.A., Kazakov N.V., Papaian G.V., Chistiakov I.V. Photodynamic therapy for R1 lung cancer resections. Grekov's Bulletin of Surgery. 2019;178(1):21-24. (In Russ.) https://doi.org/10.24884/0042-4625-2019-178-1-21-24
Views:
827
Email this article 