fluorescent light bronchoscopy plus white light bronchoscopy for early detection of lung cancer

Conditions: Head and Neck Cancer; Lung Cancer

Summary: rationale: fluorescent bronchoscopy, when used in combination with conventional white light bronchoscopy, may improve the ability to detect early lung cancer. purpose: a pilot study to evaluate fluorescent light bronchoscopy plus conventional bronchoscopy as a tool for screening and detecting lung cancer in persons with completely resected head and neck cancer or successfully treated early-stage lung cancer.

objectives: * evaluate the efficacy of autofluorescence bronchoscopy using the lung imaging fluorescence endoscopic system with conventional white-light bronchoscopy for the early detection of lung cancer in selected patients with known or suspected bronchogenic carcinoma, completely resected head and neck cancer, and successfully treated early-stage lung cancer. * determine the number of areas of moderate dysplasia, severe dysplasia, and carcinoma in situ in patients treated with surgery for lung cancer compared with patients treated with combined modality therapy. * determine the ability of immunohistochemistry to predict whether lesions of moderate to severe dysplasia will progress to cancer. outline: if possible, patients produce a 3-day pooled sputum sample prior to bronchoscopy. patients then undergo tracheobronchial white-light bronchoscopy followed by autofluorescence bronchoscopy using the lung imaging fluorescence endoscopic (life) device attached to a computerized video camera. visualized tissue is classified as either normal, abnormal, or suspicious. abnormal or suspicious tissue is biopsied, as is tissue from 1 or 2 randomly chosen normal sites. immunohistochemical analysis of the biopsy material is conducted without knowledge of the bronchoscopic results. patients unable to produce a sputum sample prior to bronchoscopy are required to do so after bronchoscopy. projected accrual: a total of 70 patients will be entered.

Eligibility criteria:
disease characteristics: * the following diagnoses are eligible: * known or suspected bronchogenic carcinoma scheduled for bronchoscopy as part of standard diagnostic or staging work-up * completely resected stage i/ii non-small cell lung cancer with no evidence of metastasis * stage iii non-small cell lung cancer with no evidence of disease for at least 2 years following treatment * small cell lung cancer with no evidence of disease for at least 2 years following treatment * completely resected head and neck cancer with no evidence of metastasis * ability to produce sputum samples required patient characteristics: age: * 18 and over performance status: * ecog 0-2 hematopoietic: * wbc 2,000-20,000 * platelets at least 50,000 hepatic: * not specified renal: * not specified cardiovascular: * no uncontrolled hypertension (i.e., systolic pressure greater than 200 mm hg or diastolic pressure greater than 120 mm hg) * no unstable angina other: * no bleeding disorder * no allergic reaction to topical lidocaine * no pregnant women prior concurrent therapy: biologic therapy * not specified chemotherapy * not specified endocrine therapy * not specified radiotherapy * at least 18 months since ionizing radiotherapy to the chest surgery * see disease characteristics other * at least 1 month since yttrium-aluminum-garnet (yag) laser therapy to the lung * at least 3 months since fluorescent photosensitizing drugs (e.g., photofrin)

Keywords: stage i non-small cell lung cancer stage ii non-small cell lung cancer stage iii non-small cell lung cancer limited stage small cell lung cancer stage i nasopharyngeal cancer stage ii nasopharyngeal cancer stage iii nasopharyngeal cancer stage i lip and oral cavity cancer stage ii lip and oral cavity cancer stage iii lip and oral cavity cancer stage i hypopharyngeal cancer stage ii hypopharyngeal cancer stage iii hypopharyngeal cancer stage i laryngeal cancer stage ii laryngeal cancer stage iii laryngeal cancer stage i paranasal sinus and nasal cavity cancer stage ii paranasal sinus and nasal cavity cancer stage iii paranasal sinus and nasal cavity cancer stage i oropharyngeal cancer stage ii oropharyngeal cancer stage iii oropharyngeal cancer