We reviewed the outcome of combined photodynamic therapy (PDT) and high dose rate brachytherapy
(HDR) for patients with symptomatic obstruction from endobronchial non-small cell lung cancer. Methods: Nine
patients who received combined PDT and HDR for endobronchial cancers were identified and their charts reviewed.
The patients were eight males and one female aged 52-73 at diagnosis, initially presenting with various stages of disease:
stage IA (N=1), stage IIA (N=1), stage III (N=6), and stage IV (N=1). Intervention was with HDR (500 cGy to 5 mm
once weekly for 3 weeks) and PDT (2 mg/kg Photofrin, followed by 200 J/cm<sup>2</sup> illumination 48 hours post infusion).
Treatment group 1 (TG-1, N=7) received HDR first; Treatment group 2 (TG-2, N=2) received PDT first. Patients were
followed by regular bronchoscopies. Results: Treatments were well tolerated, all patients completed therapy, and none
were lost to follow-up. In TG-1, local tumor control was achieved in six of seven patients for: 3 months (until death), 15
months, 2+ years (until death), 2+ years (ongoing), and 5+ years (ongoing, N=2). In TG-2, local control was achieved in
only one patient, for 84 days. Morbidities included: stenosis and/or other reversible benign local tissue reactions (N=8);
photosensitivity reaction (N=2), and self-limited pleural effusion (N=2). Conclusions: Combined HDR/PDT treatment
for endobronchial tumors is well tolerated and can achieve prolonged local control with acceptable morbidity when PDT
follows HDR and when the spacing between treatments is one month or less. This treatment regimen should be studied
in a larger patient population.