Medical thoracoscopic photodynamic therapy for metastatic pleural tumors with malignant effusion: an exploratory pilot study.

Background: The optimal treatment for malignant pleural effusion (MPE) remains controversial. We previously explored the use of minimally invasive medical thoracoscopic thermal ablation [argon plasma coagulation (APC)] to reduce pleural tumors and manage effusion, achieving encouraging results. However, this method has some drawbacks. Methods: We conducted an exploratory pilot study to evaluate the efficacy of photodynamic therapy (PDT), alone or in combination with APC, in the treatment of pleural spread with MPE. Patients with plaque-like lesions received PDT alone with an energy density of 384 J/cm Results: In total, 28 patients with non-small lung cancer (NSCLC) were enrolled. Eight patients underwent PDT alone and 20 patients underwent PDT and APC. At week 6, the overall response rate in the observation group was 82.1% (complete response in 15 cases and partial response in eight cases). At week 12, this rate had increased to 89.3%. The TTP was significantly longer in the PDT ± APC group than in the APC group (median, 20.7 vs. 14.2 months; Conclusion: Medical thoracoscopic PDT ± APC therapy significantly improved TTP relative to APC alone and provided durable local effusion control among NSCLC patients with MPE.