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K. Rathnam



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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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      P1.24-016 - Single agent oral etoposide for elderly and infirm advanced non small cell lung cancer : A reasonable therapeutic option (ID 1317)

      09:30 - 16:30  |  Author(s): K. Rathnam

      • Abstract

      Background
      Background: The use of chemotherapy has been shown to increase the effectiveness of best supportive care (BSC) in elderly patients with non-small cell lung cancer (NSCLC). The use of Intravenous chemotherapy ( IV ) has many times been difficult in elderly patients or patients with poor performance status owing to fear of toxicity.We studied the effectiveness of a non toxic regimen with single agent oral chemotherapy with etoposide plus best supportive care versus best supportive care alone in subjects with advanced non small cell lung cancer unfit for IV chemotherapy

      Methods
      Eighty five cases of advanced non small cell lung cancer and ECOG performance status of 2 to 3 , unfit for IV chemotherapy as per treating physician's discretion were included in the study. Forty three patients received chemotherapy with Tablet Etoposide 50 mg once daily for 14 days along with best supportive care ( BSC )every 21 days for a maximum of 8 cycles in responding patients. Regimen was re challenged on progression. The remaining received BSC only.

      Results
      We measured at least 1 of the following outcomes: Overall survival ( OS ) or treatment-related mortality. Overall, patients that received chemotherapy plus BSC had significant longer OS than those that received BSC alone (HR 0.75; 95%CI, 0.68–0.82; P,0.001). Additionally, chemotherapy plus BSC as compared to BSC alone resulted in a 24% RR reduction (95%CI: 10–38; P = 0.001) in 6-month mortality, 10% RR reduction (95%CI: 8–15; P,0.001) in 12-month mortality and 6% RR reduction (95%CI: 2–9; P = 0.02) in 2-year mortality. Toxicity was not significantly greater in patients who received chemotherapy plus BSC.

      Conclusion
      Chemotherapy with single agent oral etoposide plus BSC is a non toxic therapeutic option in infirm and elderly NSCLC patients unfit to receive intravenous chemotherapy.

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    P2.24 - Poster Session 2 - Supportive Care (ID 157)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P2.24-019 - Pleurodesis with bleomycin in advanced non small cell lung cancer: A single centre experience from Southern India (ID 1319)

      09:30 - 16:30  |  Author(s): K. Rathnam

      • Abstract

      Background
      Pleurodesis is an accepted therapy for patients with recurrent and massive pleural effusion in patients with advanced non small cell lung cancer.Bleomycin is safe and effective for chemical pleurodesis in several studies.The aim of this study was to study the effectiveness of bleomycin pleurodesis in advanced non small cell lung cancer.

      Methods
      Seventy five cases of proven non small cell lung cancer ; with recurrent and symptomatic pleural effusion admitted to our hospital between 2006 - 2012 were included in the study. All patients received chemical pleurodesis with 60 units of bleomycin after pleurocentesis using intercostals drainage.All patients received systemic chemotherapy following pleurodesis.

      Results
      The clinical control of pleural effusion by 4 weeks of procedure and the need for a repeat pleurodesis was analysed.The success rate was 76.7 per cent (95% CI,68.6 – 88.7 %). The only significant complication reported was chest pain of varying degrees. There were no deaths associated with bleomycin pleurodesis.

      Conclusion
      Bleomycin pleurodesis may be considered as safe and cost effective treatment in patients with advanced non small cell lung cancer with symptomatic pleural effusion in developing countries.