Curative Endobronchial Therapy in Early-Stage Non-Small Cell Lung Cancer

Abstract
Bronchoscopic treatment has a curative potential in patients with early-stage non-small cell lung cancer. For earlystage intraluminal squamous cell carcinoma including carcinoma in situ, its potential to obtain long-term complete response has been established in phase II studies. Several bronchoscopic techniques are available for the treatment of these tumors. Success of bronchoscopic treatment depends on malignant behavior, localization, and size of the tumor. Only centrally located, superficial-growing, strictly intraluminal tumors are accessible for bronchoscopic treatment with a curative intent. Accurate tumor staging is therefore important to properly select patients who are candidates for this treatment. Early detection and staging by using new diagnostic tools, e.g., fluorescence bronchoscopy, high-resolution computed tomography, and bronchoscopic ultrasonography, may improve the relatively inaccurate conventional staging methods. This is especially important when bronchoscopic therapy is applied as an alternative for surgical resection. Screening of the population at risk may increase the number of patients who are suitable for bronchoscopic treatment with a curative intent. This article discusses the background, indications, diagnostic procedures, treatment techniques, and results of bronchoscopic treatment with curative intent in early-stage non-small cell lung cancer.