Terapia fotodinámica: aplicación en dos pacientes con metástasis endobronquiales de adenocarcinoma extrapulmonar

Abstract

Photodynamic therapy is based on the iv administration of a photosensibilizant drug (usually an hematoporphyrin derivative). This complex is intensively uptaken by the tumoral cells. Later, a laser photostimulation whose potency and wave length has been pre established, is applied through a flexible bronchoscopy. Using this method, singlet state excited oxygen molecules are generated, producing a series of structural changes that lead to cell destruction. Based on this principle, this therapy has been used in multiple parenchymas: skin, esophagus, bladder, retina, bronchial tree and so on. In relation to this last parenchyma, the published evidence supports this technique because it induces long permeabilization periods of obstructive bronchial tumours in non-small cells cancers and in endobronchial metastases of non-pulmonary primary cancer. In this first national experience, we present two pacients with an advanced extrapulmonary adenocarcinoma with endobronchial metastases. In both (the first one with colon cancer and the second with breast cancer), we have achieved a satisfactory and continued bronchial permeabilization of the right bronchial tree for 5 and 3 months respectively. The beginning of this therapy in our country has continued with other successful applications done by our team in esophagus and skin, creating a working and studying area on this field. In this paper we also reviewed its theorical base and application forms.