Photodynamic therapy for central-type early-stage lung cancer.

Photodynamic therapy has been considered as the first choice of treatment for central-type early-stage lung cancer. Recent advances in the comprehensive diagnosis of central-type early-stage lung cancer and the selection of a good indication for photodynamic therapy have been anticipated to improve the therapeutic outcome of this type of early-stage lung cancer. In terms of enrollment, evaluation of the tumor area on the bronchial surface and the depth of invasion in the bronchial wall is important. Autofluorescence bronchoscopy and endobronchial ultrasonography have shown considerable impact on diagnostic bronchoscopy for this type of lung cancer. In terms of size, central-type early-stage lung cancer of < 1 cm diameter has shown a favorable cure rate by photodynamic therapy. The development of photodynamic therapy with a new photosensitizer is expected to further expand its indications to encompass even large tumors of > 1.0 cm diameter owing to its stronger effect. We postulate that the indication of photodynamic therapy will expand to larger central tumors together with a possible therapeutic option for peripheral early cancer.