[The randomized study of efficiency of preoperative photodynamic].

The authors made a prospective randomized comparison of results of preoperative photodynamic therapy (PhT) with chemotherapy, preoperative chemotherapy in initial unresectable central non-small cell lung cancer in stage III. The efficiency and safety of preoperative therapy were estimated as well as the possibility of subsequent surgical treatment. The research included patients in stage IIIA and IIIB of central non-small cell lung cancer with lesions of primary bronchi and lower section of the trachea, which initially were unresectable, but potentially the patients could be operated on after preoperative treatment. The photodynamic therapy was performed using chlorine E6 and the light of wave length 662 nm. Since January 2008 till December 2011,42 patients were included in the research, 21 patients were randomized in the group for photodynamic therapy and 21--in group without PhT. These groups were compared according to their sex, age, stage of the disease and histological findings. After nonadjuvant treatment the remissions were reached in 19 (90%) patients of the group with PhT and in 16 (76%) patients without PhT and all the patients were operated on. The explorative operations were made on 3 patients out of 16 operated on in the group without PhT (19%). In the group PhT 14 pneumonectomies and 5 lobectomies were perfomed opposite 10 pneumonectomies and 3 lobectomies in group without PhT. The degree of radicalism of resection appears to be reliably higher in the group PhT (RO-89%, R1-11% as against RO-54%, R1-46% in group without PhT), p = 0.038. The preoperative endobronchial PhT conducted with chemotherapy was characterized by efficiency and safety, allowed the surgical treatment and elevated the degree of radicalism of this treatment in selected patients, initially assessed as unresectable.

[Photodynamic therapy in combined treatment of stage III non-small cell lung carcinoma].

The aim of the study was to evaluate the effectiveness of combined treatment of locally advanced lung cancer with the use of neoadjuvant chemotherapy and surgery with the use of pre- and intraoperative photodynamic therapy. 20 patients with IIIa (n=7) and IIIb (n=13) stage of non-small cell lung carcinoma were included. At the time of diagnosis the surgical treatment was decided to abstain because of the trachea invasion in 9 patients, wide mediastinal invasion in 2 patients and contralateral mediastinal lymph nodes metastases in 2 patients; pneumonectomy was not possible due to the poor respiratory function in 7 patients. Neoadjuvant therapy included 3 courses of chemotherapy and endobronchial photodynamic therapy. During the operation, along with the lung resection (pneumonectomy - 15, lobectomy - 5), photodynamic therapy of the resection margins were carried out. No adjuvant treatment was done. Preoperative treatment led to partial regress of the disease in all cases; the goal of surgery was the complete tumor removal. No complications of the photodynamic therapy were observed. 18 surgical interventions were radical and two non-complete microscopically (R1). Postoperative morbidity was 20%, one patient died due to massive gastrointestinal bleeding. The average follow-up period was 18 months: 19 patients were alive, of them 18 with no signs of the disease recurrence. The first experience of the combined use of neoadjuvant chemotherapy and surgery with pre- and intraoperative photodynamic therapy demonstrates safety and efficacy of the suggested treatment tactics.

[On the possibilities of correction of changes of the gastrointestinal tract microbiota in patients with lung cancer treated receiving chemotherapy].

UNLABELLED: The aim of the study was the improvement of technologies of treatment of patients with the lung cancer receiving chemotherapy on the basis of using with the complex therapy of the combined probiotic based on the Bacillus subtilis strain. MATERIALS AND METHODS: 30 patients with the lung cancer receiving the first and second line of the first cycle of chemotherapy were included. The age of patients varied from 49 to 73 years, the average duration of the disease was 1 year. Patients of the main group (n = 21) received the combined probiotic based on the Bacillus subtilis strain together with the chemotherapy course. Patients of control group (n = 9) received only chemotherapeutic preparations. All patients were observed before and after treatment: the standardized inquiry for detection of intestinal complaints, microbiological research of feces (definition of qualitative and quantitative characteristics of gut microbiota), the research of metabolites of intestinal microorganisms in blood by the method of the gas-liquid chromatography - mass-spectrometry by G. A. Osipov's method. The efficiency of probiotic therapy was evaluated by results of studied indicators dynamics. RESULTS: Main symptoms of the intestinal dyspepsia were observed in patients with the lung cancer receiving chemotherapy such as constipation and intestinal microflora violations (decreased quantity of Lactobacillus, Bifidobacterium, Bacteroides and increased quantity of different pathogenic microorganisms). It was noted decreased rate of intestinal dyspepsia symptoms and improvement of intestinal microflora composition after the treatment course by the combined probiotic based on the Bacillus subtilis strain. CONCLUSION: Using of probiotic medicines with the chemotherapy in lung cancer patients is promising to reduce the frequency of gastrointestinal complaints and prevent deterioration of the gut microflora.

[Application of photodynamic therapy to reduce the amount of resection for non-small cell lung cancer].

A prospective analysis of results of combined treatment of 22 patients with central stage II-III non-small cell lung cancer (NSCLC) was performed (the defeat of the main bronchi or lower parts of the trachea), which initially had been regarded as unresectable or inoperable (12 patients for functional reasons could not pass pneumonectomy, and in 10 patients a contraindication to primary surgery was the involvement of the distal trachea in tumor), but underwent surgery after preoperative treatment.Combination therapy included preoperative endobronchial photodynamic therapy (PDT) and chemotherapy followed by surgery and intraoperative PDT resection margins. PDT was carried out with the use of chlorine E6 (Radachlorin) and light wavelength of 662 nm. Overall response rate after neoadjuvant treatment was 82 %, endoscopic remission was observed in 21 of 22 patients (95%). 10 patients underwent pneumonectomy, 12--lobectomy. 19 surgical interventions were regarded as radical (R0--86%), 3--as microscopically non-radical (R1--14%). Degree of lymphatic metastasis spreading pN0 was detected in 6 patients (27 %), pN1--in 14 (64%) and pN2--in 2 patients (9%). Surgical lethality was 5%. In the late time of the whole observation period none of the patients developed local recurrence. One-year survival was 95%, 3-year--91%. PDT can play an important role in combination with surgical treatment for NSCLC and reduces the amount of resection in part of initially unresectable or inoperable patients.

[Photodynamic therapy in treatment of lung cancer].

The effectiveness of photodynamic therapy was studied in 20 patients with different stages of lung cancer. We used the photosensitizer--PHOTOHEM and gold vapor laser (Auran). Photodynamic therapy was combined with high-energy laser photodestruction of tumors in 7 patients. In late (IIIb and IV) cancers the application of photodynamic therapy has significantly reduced the tumor tissue of bronchial obstruction in 9 out of 12 (75%) patients with improvement of the respiratory function, disappearance of atelectases. Photodynamic therapy was less effective in bronchoscopic signs of infiltrative tumor growth, typical for its peribronchial form. In the early stages of cancer the application of photodynamic therapy allowed complete removal of the tumor. However, 2 out of 8 patients showed signs of residual tumor growth within 1-3 months which disappeared due to repeated treatments with photodynamic therapy.