Hematoporphyrin derivative phototherapy in the treatment of bronchogenic carcinoma.

Nineteen patients with cancer involving the tracheobronchial tree (a total of 20 carcinomas) have completed at least one course of hematoporphyrin derivative phototherapy administered via the flexible fiberoptic bronchoscope. Seven patients (eight carcinomas) have shown a complete response. In six of these patients (seven carcinomas), there has been no recurrence of tumor at the site of treatment during follow-up ranging from 8 to 31 months. One patient had a complete response lasting 12 months, but subsequently had a local recurrence producing obstruction; this patient died 24 months after the initial hematoporphyrin derivative phototherapy. Eight other patients had less than a complete response and required alternative therapy. Three of these eight patients died, one of metastases and two of airway obstruction and metastases. The four remaining patients died before results of this local therapy could be assessed; two died of metastases and two of hemoptysis. The cancers in patients who had a complete response were less than 3 sq cm in surface area and appeared superficial at bronchoscopy. Therefore, hematoporphyrin derivative phototherapy does have the potential to become an alternative to surgical resection as the primary treatment in carefully selected patients.