In this issue of Thorax, Moghissi et al¹ report their experience of treating a selected group of patients with porphyrin-based photodynamic therapy (PDT) (see p 391). These patients had localised early bronchogenic carcinomas without lymphadenopathy or distant metastases. They could not undergo surgery because of their overall clinical condition and half of them had been operated on before. Recognised as a world class thoracic surgeon, Mr Moghissi is certainly not questioning the value of surgery. Only after alternatives such as parenchymal-sparing bronchoplasty had been definitely excluded was PDT with curative intent offered. PDT was applied with a single laser light illumination using rigid bronchoscopy under general anaesthesia. Such a treatment usually takes less than 20 minutes, and at the Yorkshire Laser Centre it is performed as a day case procedure.

This is a solid and honest report from probably Europe’s most active PDT centre. At first sight the statement that “complete response was achieved in all of the 21 patients” builds a strong case for this type of treatment. …