肺癌に対するInterventional Bronchology

Patients with advanced bronchogenic carcinomas that obstruct the central airway have been treated by Nd-YAG laser and tracheobronchial prostheses. The Nd-YAG laser delivers radiation at 1,064 nm, acts directly on malignant tissues causing thermonecrosis and vaporization. Tracheal and endobronchial prostheses have used as additional means for establishing and maintaining patent airway. These palliative therapies contribute to improving and maintaining the QOL of the patients. Methods of treatment for early superficial occult squamous cell carcinoma of the lung are bronchoscopic photodynamic therapy (PDT) and brachytherapy. PDT is used by photosensitizing agents (hematoporphyrin) that accumulate in malignant tissue and can be activated by a laser energy. Brachytherapy is technique for endobronchial irradiation involves the use of 192Ir. Both treatments are well effective for early superficial occult squamous cell carcinoma of the lung (CR rate is approximately 80%). They are safe and preserve pulmonary parenchyma.