The Curative Potential of Intraluminal Bronchoscopic Treatment for Early-Stage Non–Small-Cell Lung Cancer

Bronchoscopic treatment modalities such as lasers, electrocautery, cryotherapy, photodynamic therapy, and brachytherapy are potentially curative for patients with very-early-stage non–small-cell lung cancer (NSCLC) in the central airways. Previously, studies had primarily focused on the effectivenes...

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Bibliographic Details
Published in:Clinical lung cancer 2001-05, Vol.2 (4), p.264-270
Main Authors: Sutedja, Tom G., van Boxem, Anton J., Postmus, Pieter E.
Format: Article
Language:English
Subjects:
Autofluorescence bronchoscopy
Brachytherapy
Cryotherapy
Endobronchial ultrasound
Laser-induced fluorescence endoscope
Optical computed tomography
Photodynamic therapy
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Summary:Bronchoscopic treatment modalities such as lasers, electrocautery, cryotherapy, photodynamic therapy, and brachytherapy are potentially curative for patients with very-early-stage non–small-cell lung cancer (NSCLC) in the central airways. Previously, studies had primarily focused on the effectiveness of surgery, surgical bronchoplasty, and photodynamic therapy. The cure rate of intraluminal bronchoscopic treatment is strongly related to the patient's functional status and tumor stage. Intraluminal tumors are curable bronchoscopically when they are accessible to the fiberoptic bronchoscope, strictly intraluminal, and superficial with visible proximal and distal tumor margins. Early-stage cancer infiltrating deeper into the bronchial wall may already harbor metastases to the regional lymph nodes; hence, curative intraluminal treatment is not feasible. The use of new diagnostic tools (eg, high-resolution computed tomography, autofluorescence bronchoscopy, and endobronchial ultrasound) may improve staging to select the category of patients in whom intraluminal bronchoscopic therapy with curative intent is appropriate. An accurate intraluminal tumor staging will improve our ability to exploit the curative potential of many bronchoscopic techniques for complete tumor eradication in patients with very-early-stage intraluminal NSCLC in their central airways. The use of bronchoscopic treatment as a less morbid alternative than surgical resection will benefit patients most when tumor is detected at the earliest stage possible.
ISSN:1525-7304
1938-0690
DOI:10.3816/CLC.2001.n.009