Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Photodynamic therapy (PDT) is used for the treatment of centrally-located early lung cancers (CLELCs) and is recommended for tumors ≤ 1.0 cm in diameter. We previously reported that PDT using talaporfin sodium, second-generation photosensitizer, for tumors > 1.0 cm but ≤ 2.0 cm in diameter was able to achieve a therapeutic outcome comparable to that of tumors with a diameter of ≤ 1.0 cm. However, the effectiveness of PDT using talaporfin sodium for tumors > 2.0 cm in diameter remains unclear. We conducted a retrospective analysis of cases in which PDT was performed for flat-type CLELCs with tumor diameters of > 2.0 cm. METHODS: We retrospectively analyzed seven cases (eight lesions) with tumor diameters > 2.0 cm and no evidence of extracartilaginous invasion or lymph node metastasis. RESULTS: All the patients underwent multiple PDT sessions. The PDT treatment results over the study period were partial response in one case (14.3 %), stable disease (SD) in three cases (42.9 %), and progressive disease (PD) in three cases (42.9 %). At the time of writing this report, five of seven cases (71.4 %) are still undergoing treatment. The duration of SD-the time from the start of treatment until the criteria for PD were met (SD or better maintained)-ranged from 7 to 52 months (mean, 25.3 months). CONCLUSIONS: "Maintenance PDT" for CLELCs > 2.0 cm in diameter has the potential to inhibit tumor progression in the long term while maintaining quality of life, rather than simply aiming only for a quick radical cure.

DOI： 10.1016/j.pdpdt.2024.104200

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The da Vinci Si version robot lacks a vascular stapler that can be controlled by the operating surgeon at the surgical console when dividing pulmonary vessels. Therefore, to initiate and safely perform robotic anatomical lobectomy for lung cancer, it is important to develop a safe method for introducing a surgical stapler. METHODS: We performed a retrospective study of the first 42 consecutive patients who underwent robotic lobectomy for lung cancer at Nippon Medical School Hospital between January 2019 and December 2020. RESULTS: Up to case 18, we performed robot-assisted thoracoscopic surgery (RATS) lobectomy by using a four-arm approach with two assistant ports. For dividing pulmonary vessels, the surgical stapler was introduced through the assist ports. However, since this is not the port position usually used in video-assisted thoracoscopic surgery (VATS), there were many difficult situations. For RATS lobectomy case 19 and all subsequent cases, we utilized a total port approach that uses three robotic arms and two assistant ports. To resect the pulmonary vessels or bronchi with endoscopic staplers, the port for the robotic arm was removed and the endoscopic staplers were placed through a 12-mm Xcel bladeless port. This change reduced operation time, blood loss, and robotic arm interference. No patient developed intraoperative complications during RATS lobectomy. CONCLUSION: The present total port approach, with three robotic arms, appears to be feasible for introducing surgical staplers during RATS with the da Vinci Si robotic system.

DOI： 10.1272/jnms.JNMS.2022_89-211

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Language：Japanese   Publisher：(NPO)日本レーザー医学会  

光線力学的治療(photodynamic therapy:PDT)は中心型早期肺癌に対する標準的な治療法の一つであり,その治療成績向上のためには,腫瘍の範囲を正確に診断し,適切にレーザー照射を行うことが重要であるが,一部の内視鏡システムは,光感受性物質であるタラポルフィンナトリウム注射後の腫瘍進展範囲の評価に不向きである点や,レーザー光により色情報が担保できず,適切なレーザー照射に苦慮するなどの課題があった.今回は,同時式内視鏡システムELUXEO 7000(富士フイルム株式会社)を用いてPDTの治療成績向上に向けた工夫を検討した.(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J01213&link_issn=&doc_id=20220602390001&doc_link_id=%2Fcd0rezae%2F2022%2F004301%2F002%2F0002-0008%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcd0rezae%2F2022%2F004301%2F002%2F0002-0008%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publishing type：Research paper (scientific journal)  

BACKGROUNDS: It is not uncommon to encounter metachronous primary lung cancer after surgical treatment along with the increase in the elderly patients. In consideration of increasing number of such patients, it is necessary to take various treatment strategies. METHODS: In order to establish a treatment strategy for multiple lung cancer, we retrospectively examined multiple lung cancer cases operated for primary lung cancer in our department from January 2013 to December 2019, and the future treatment strategy was examined. RESULTS: Of 821 patients who underwent surgery for primary lung cancer, 61 were multiple lung cancers, 31 were synchronous multiple lung cancers, and 30 were metachronous multiple lung cancers. Among the cases of metachronous multiple lung cancer, 28 cases had undergone lobectomy or more in the first operation, 1 case of segmental resection, and 1 case of partial resection. As for the treatment of secondary lung cancer lesions, 21 lesions were performed surgery( lobectomy;2, segmental resection;2, partial resection;17), 6 lesions of photodynamic therapy (PDT), and 3 lesions of stereotactic body radiation therapy (SBRT). Among the surgical cases, there were three cases on the same side as the first cancer and 18 cases on the opposite side. The three cases underwent partial resection. Among 21 patients, postoperative home oxygen therapy was introduced in 2 patients. Regarding the prognosis, three patients who had surgical resection, died of recurrence of the first lesion. One of the six PDT patients died of recurrence of the first lung cancer and another died of other disease. All three patients who underwent SBRT are alive without recurrence. CONCLUSIONS: If early detection and early diagnosis are made as a treatment strategy for metachronous multiple lung cancer, it may be possible to preserve lung function by reducing surgery or SBRT, PDT, and to cure without damaging the quality of life.

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Language：Japanese   Publisher：日本胸部外科学会-関東甲信越地方会  

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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Language：Japanese   Publisher：(NPO)日本肺癌学会  

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Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

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