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H. Sengyoku



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    P1.10 - Poster Session 1 - Chemotherapy (ID 204)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.10-038 - A phase II trial of the combination of gemcitabine and carboplatin as adjuvant chemotherapy in patients with completely resected non-small cell lung cancer. (Kenbyo 0601) (ID 2185)

      09:30 - 16:30  |  Author(s): H. Sengyoku

      • Abstract

      Background
      Background: Adjuvant chemotherapy for resected non-small cell lung cancer (NSCLC) is recommended with survival benefit, however low compliance in recent clinical trials. Objectives: We conducted a phase II trial of gemcitabine(G) and carboplatin(C) regimen for patients with completely resected NSCLC and carboplatin is administrated on day 8 to reduce hematological toxicity especially thrombocytopenia.

      Methods
      Eligibility criteria included: PS(ECOG) 0-1, age≦75 years, p-stage IB-IIIA NSCLC is complexly resected (R0), adequate hematological liver renal and cardiac function. Regimen: G (1000mg/m2) d1 +8 and C (AUC 5, d8) q.3wks. Primary end point of this study is feasibility and secondary end points are toxicity, overall and disease-free survival.

      Results
      44 patients (20 male, 24 female) were included, median age 63 (40-71) years. Adenocarcinoma in 39, squamous cell ca. in 4, pleomorphic ca. in 1, and pathological stage IB in 25, IIA in 8, IIB in 5, and IIIA in 6 patients. Thirty-three patients (75%) completed the planned 4 cycles of GC therapy and 28 (64%) received the planned doses. Thirty-four percent of the patients had grade 3/4 neutropenia, 2 (6%) had thrombocytopenia, and the other 2 (6%) had anemia. Non-hematological adverse effects were infrequent and no treatment-related death was noted in this study.

      Conclusion
      Hematological toxicity, especially thrombocytopenia in this study is less than that in the standard administration of CG (C day1) regimen. We conclude that this regimen is feasible with sufficient compliance as adjuvant chemotherapy for completely resected stage IB-IIIA NSCLC patients.

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    P1.24 - Poster Session 1 - Clinical Care (ID 146)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P1.24-021 - Bronchoplasty and bronchoangioplasty for primary non-small cell lung cancer (ID 1595)

      09:30 - 16:30  |  Author(s): H. Sengyoku

      • Abstract

      Background
      The objective of this study was to evaluate the operative mortality, morbidity, and survival of bronchoplasty and bronchoangioplasty for non-small cell lung cancer. Multivariate analysis was done to determine potential prognostic factors for both procedures based on our 27-year single-center experience.

      Methods
      Between January 1985 and March 2012, 204 bronchoplastic procedures were done in 1978 patients who underwent lung resections for non-small cell lung cancer at Nagasaki University Hospital. After excluding 18 carino-plasty patients and 13 wedge angioplasty of pulmonary artery, 173 patients (141 bronchoplasty and 32 broncho-angioplasty) were included.

      Results
      In the bronchoplasty group, the postoperative morbidity was 29% (41/141) and the 90-day postoperative mortality was 5.7% (8/141), while in the broncho-angioplasty group the postoperative morbidity was 28% (9/32) and the postoperative mortality was 15.6% (5/32). Eleven patients (6.4%) experienced bronchopleural fistulas. Multivariate analysis demonstrated that induction therapy (p=0.047) and combined multiple organ resection (p=0.012) were risk factors for postoperative anastomotic complication. The 5-year survival rate for all patients was 46.3%. The 5-year survival rate was 69.5% in patients with pathological stage I disease. In patients with stage II disease, the 5-year survival rate was 34.7%. In patients with stage III-IV disease, the 5-year survival rate was 33.2%. The survival rate in stage I disease was significantly better compared with other stage disease (p<0.0003). Multivariate analysis indicated that the type of operation (bronchoplasty versus bronchoangioplasty), postoperative complications, histologic type (squamous cell carcinoma versus non squamous cell carcinoma), and pN status (N0-1 versus N2-3) were significant factors affecting survival.

      Conclusion
      Both bronchoplasty and broncho-angioplasty are useful for the treatment of patients with non-small cell lung cancer and should be performed in stage I. However, careful patient selection is mandatory in patients with advanced tumor stages and in those with nonsquamous cell carcinoma, especially if broncho-angioplasty is being considered.