Photodynamic therapy (
PDT) is a form of non-ionizing radiation
therapy that uses a drug, called a
photosensitizer, combined with light to produce
singlet oxygen ((1)O2) that can exert anti-
cancer activity through apoptotic, necrotic, or autophagic
tumor cell death.
PDT is increasingly being used to treat thoracic
malignancies. For early-stage
non-small cell lung cancer (NSCLC),
PDT is primarily employed as an endobronchial
therapy to definitively treat endobronchial or roentgenographically occult
tumors. Similarly, patients with multiple primary
lung cancers may be definitively treated with
PDT. For advanced or metastatic NSCLC and
small cell lung cancer (SCLC),
PDT is primarily employed to palliate symptoms from obstructing endobronchial lesions causing airway compromise or
hemoptysis.
PDT can be used in advanced NSCLC to attempt to increase operability or to reduce the extent of operation intervention required, and selectively to treat pleural dissemination intraoperatively following macroscopically complete surgical resection. Intraoperative
PDT can be safely combined with macroscopically complete surgical resection and other treatment modalities for
malignant pleural mesothelioma (MPM) to improve local control and prolong survival. This report reviews the mechanism of and rationale for using
PDT to treat thoracic
malignancies, details prospective and major retrospectives studies of
PDT to treat NSCLC, SCLC, and MPM, and describes improvements in and future roles and directions of
PDT.