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Review
. 2021;13(6):78-86.
doi: 10.17691/stm2021.13.6.09. Epub 2021 Dec 28.

Photodynamic Theranostics of Central Lung Cancer: Capabilities of Early Diagnosis and Minimally Invasive Therapy (Review)

G V Papayan  1 , A L Akopov  2
Affiliations
Review

Photodynamic Theranostics of Central Lung Cancer: Capabilities of Early Diagnosis and Minimally Invasive Therapy (Review)

G V Papayan et al. Sovrem Tekhnologii Med. 2021.

Abstract

The aim of the study was to assess the prospects for central lung cancer (CLC) screening using fluorescent diagnostics and its treatment by endobronchial photodynamic therapy (PDT). Bronchoscopic fluorescent diagnostics using chlorin e6 photosensitizers and a developed instrumental system enable to reveal tumor changes in large bronchi mucosa at early stages, and a developed PDT technique performed under fluorescent control helps achieve personalized treatment. Such an approach is considered as a theranostic technique - photodynamic theranostics. central lung cancer screening requires a fluorescent dye characterized by availability and can be used directly within the examination. Indocyanine green can be used as a dye, its peculiarity is the necessity to excite and record fluorescence in the near-infrared (NIR) wavelength band. First experiments using NIR bands to diagnose a bronchoscopic system showed the detectability of tumor areas using on-site bronchoscopic photodynamic theranostics, which consists in NIR imaging of tumor foci when a standard dose of indocyanine green is administered during the examination.

Conclusion: Further progress of early diagnostics and minimally invasive CLC therapy will be determined by the development of new photosensitizers, which should be characterized by a high absorption band in NIR area, quick accumulation in a tumor, high yield of single oxygen in NIR illumination, bright fluorescence, high potential in terms of the induction of an anti-tumor immune response.

Keywords: central lung cancer; chlorin е6; fluorescent diagnosis; indocyanine green; lung cancer screening; photodynamic theranostics; photodynamic therapy; photosensitizers.

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Conflict of interest statement

Conflicts of interest. The authors declare no conflicts of interest related to the present study.

Figures

Figure 1.
Figure 1.. Paired photos of bronchial mucous area in the white light (а) and in fluorescent light (b) in a patient with central squamous cell lung cancer
Figure 2.
Figure 2.. Bronchial mucosa photos taken in double fluorescent staining (indocyanine green + Radachlorin) in near-infrared light (а), (c) and visible (b), (d) fluorescence prior to (а), (b) and at the end of photodynamic radiation (c), (d)
See this image and copyright information in PMC

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