Outcomes and Deliberations of Laser Therapy in Patients with Primary Lung Cancer

laser therapyAll 20 patients (18 males, two females) receiving laser therapy have had primary endobronchial carcinoma (Table 1). Seventeen patients were hospitalized for symptoms related to their tumor. The other three patients were admitted only for the laser procedure. Cell types were: squamous cell carcinoma, 13; adenocarcinoma, three; small cell carcinoma, two; and poorly differentiated carcinoma, two. Five patients required two procedures. In two of these the initial procedure failed to establish a patent airway; both had had complete obstruction of the left main-stem bronchus. The other three patients had recurrence of symptoms after 2, 5, and 8 months, respectively. Patient 16 required four procedures because of recurrence of obstruction.

Methods of Laser Therapy in Patients with Primary Lung Cancer

Lung cancerLung cancer is the most common fatal neoplasm in men and soon will be in women. Results of current therapy are disappointing and often only palliative. Chemotherapy and radiation therapy are limited by their tumor responsiveness and toxicities. In many patients the tumor spreads, leading to obstruction of a major airway with subsequent atelectasis or pneumonia, or to erosion of or invasion into vital structures or both.

The latter are difficult to diagnose and often cannot be prevented; the former, however, can be treated by laser (Zight amplification by stimulated emission of radiation) ablation through a flexible fiberoptic endoscope. Since May 1981, we have been using neodymium:yttrium-aluminum-garnet (Nd.YAG) laser palliation for patients with unresectable lung cancer. Our first 20 patients with primary lung tumors form the basis of this report.