Andrey Akopov1, Anatoly Rusanov2, Andrey Gerasin2, Nikita Kazakov2, Margarita Urtenova3, Ivan Chistyakov2. 1. Department of Thoracic Surgery, Oncology and Bronchology, Research Institute of Pulmonology, First Pavlov State Medical University, Saint-Petersburg, Russia; Department of Surgery #1, First Pavlov State Medical University, Saint-Petersburg, Russia. Electronic address: akopovand@mail.ru. 2. Department of Surgery #1, First Pavlov State Medical University, Saint-Petersburg, Russia. 3. Department of Thoracic Surgery, Oncology and Bronchology, Research Institute of Pulmonology, First Pavlov State Medical University, Saint-Petersburg, Russia.
Abstract
OBJECTIVES: This report describes the result of prospective randomized trial to assess effectiveness and safety of neoadjuvant photodynamic therapy (PDT) and chemotherapy as well as possibility for further surgery for locally advanced NSCLC. METHODS:Patients with stage IIIA and IIIB central NSCLC (main bronchus/distal trachea involvement) who were not initially eligible for surgery but might be considered as surgery candidates after neoadjuvant therapy were enrolled in the study. They were randomized to either neoadjuvant chemotherapy and endobronchial PDT or chemotherapy alone followed by surgical resection. PDT was done with photosensitizer agent chlorine E6 and 662nm laser light before each of the three courses of chemotherapy. RESULTS:From January 2008 to December 2011, 42 patients were assigned to PDT arm (n=21) and No-PDT arm (n=21). Groups were similar with respect to age, sex, tumor stage, and histology. No PDT major complications were observed. After neoadjuvant treatment partial response revealed in 19pts (90%) in PDT arm and 16pts (76%) in No-PDT arm (p=0.460), these patients underwent thoracotomy. After thoracotomy tumor was unresectable in 3pts of No-PDT arm (19%). There were 14 pneumonectomies and 5 lobectomies in PDT arm vs. 10 pneumonectomies and 3 lobectomies in No-PDT arm. Completeness of resection was significantly higher in PDT arm (R0-89%, R1-11%) vs. No-PDT arm (R0-54%, R1-46%), p=0.038. CONCLUSIONS: The study demonstrated that neoadjuvant PDT along with chemotherapy is effective, safe and it makes possible to convert to surgery candidates and to improve resection completeness in stage III central NSCLC patients.
RCT Entities:
OBJECTIVES: This report describes the result of prospective randomized trial to assess effectiveness and safety of neoadjuvant photodynamic therapy (PDT) and chemotherapy as well as possibility for further surgery for locally advanced NSCLC. METHODS:Patients with stage IIIA and IIIB central NSCLC (main bronchus/distal trachea involvement) who were not initially eligible for surgery but might be considered as surgery candidates after neoadjuvant therapy were enrolled in the study. They were randomized to either neoadjuvant chemotherapy and endobronchial PDT or chemotherapy alone followed by surgical resection. PDT was done with photosensitizer agent chlorine E6 and 662nm laser light before each of the three courses of chemotherapy. RESULTS: From January 2008 to December 2011, 42 patients were assigned to PDT arm (n=21) and No-PDT arm (n=21). Groups were similar with respect to age, sex, tumor stage, and histology. No PDT major complications were observed. After neoadjuvant treatment partial response revealed in 19pts (90%) in PDT arm and 16pts (76%) in No-PDT arm (p=0.460), these patients underwent thoracotomy. After thoracotomy tumor was unresectable in 3pts of No-PDT arm (19%). There were 14 pneumonectomies and 5 lobectomies in PDT arm vs. 10 pneumonectomies and 3 lobectomies in No-PDT arm. Completeness of resection was significantly higher in PDT arm (R0-89%, R1-11%) vs. No-PDT arm (R0-54%, R1-46%), p=0.038. CONCLUSIONS: The study demonstrated that neoadjuvant PDT along with chemotherapy is effective, safe and it makes possible to convert to surgery candidates and to improve resection completeness in stage III central NSCLCpatients.
Authors: Mikhail Grin; Nikita Suvorov; Petr Ostroverkhov; Viktor Pogorilyy; Nikita Kirin; Alexander Popov; Anna Sazonova; Elena Filonenko Journal: Biophys Rev Date: 2022-06-09
Authors: Gal Shafirstein; Athar Battoo; Kassem Harris; Heinz Baumann; Sandra O Gollnick; Joerg Lindenmann; Chukwumere E Nwogu Journal: Ann Am Thorac Soc Date: 2016-02