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Sharif Ahmed
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P1.06 - Epidemiology/Primary Prevention/Tobacco Control and Cessation (ID 692)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Epidemiology/Primary Prevention/Tobacco Control and Cessation
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.06-011 - Hyponatremia - Evaluation of Prevalence in Hospitalized Lung Cancer Patients and Its Prognostic Significance (ID 9528)
09:30 - 16:00 | Presenting Author(s): Sharif Ahmed
- Abstract
Background:
Hyponatremia is an underestimated hazardous complication; which goes side by side since diagnosis till terminal outcome of carcinoma lung patients. The aim of study is to evaluate the prevalence of hyponatremia in hospitalized lung cancer patients and influence of hyponatremia on prognosis in same group of patients.
Method:
Observational study was conducted between July, 2015 to November, 2016 in United Hospital Cancer Care Centre. A total 200 hospitalized patients were analyzed with diagnosed carcinoma lung. These subjects were free from gross liver diseases; kidney diseases and brain metastasis. Prevalence of hyponatremia including severity (mild, moderate and severe) was evaluated. The role of hyponatremia with lung cancer was also evaluated in hospital mortality. Hyponatremia was treated with oral salt, NaCl tablets along with fluid restriction to 500 mL per day. In some cases hypertonic saline was also used. In the present study we were not assessing the prevalence of SIADH but only hyponatraemia.
Result:
Among 200 patients; NSCLC were 79.5 %( n=159) and SCLC were 20.5% (n=41). Various degree of hyponatremia was found in 63.52 % ( n=101) NSCLC patients and 56.09 %( n=23) SCLC patients. There was no statistical significance in prevalence of hyponatremia between histological types of lung cancer. Out of 200 patients, 124 patients had mild, moderate and sever hyponatremia which was 61.29 %( n=76), 27.42 %( n=34) and 11.29 %( n=14) respectively. Among 124 hyponatremic patients 23.38% (n=29) died and 76.61 %( n=95) survived. And remaining 76 normo-natremic patients 10.53% (n=8) died of their illness and 89.47 %( n=68) survived. In patients with lung cancer with hyponatremia compared to patient with lung cancer without hyponatremia; a significant increase in hospital mortality was found. (23.38% Vs 10.53%) (p <0.001)
Conclusion:
Hyponatremia is common abnormality found in approximately 62% of lung cancer patients. It is also considered as a significant prognostic factor associated with mortality of lung cancer patient. In future large prospective multicenter study is needed to better understand the relation of hyponatremia in lung cancer patient for both management and outcome.
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P3.14 - Radiotherapy (ID 730)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiotherapy
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.14-006 - Slow CT Simulation for GTV Delineation and Planning of Radiotherapy to Lung Cancer Patients; A Sunshine to Developing Countries (ID 9848)
09:30 - 16:00 | Presenting Author(s): Sharif Ahmed
- Abstract
Background:
In Bangladesh lung cancer stands in the top 3 in both male & female patient. Most of the patients are diagnosed as advanced stage. Radiotherapy plays an important role in the management of lung cancer. Motion management is a big challenge in GTV & ITV delineation, RT planning and minimizing the dose to OAR (Organ at risk). In Bangladesh there are 18 LINAC (12 in private & 6 in Govt. centers) is available. But, only one centre has the facility to do 4DCT simulation (United Hospital Limited). So it is time to consider that slow CT (computerized tomography) simulation can help to delineate GTV more precisely than axial CT simulation in Radiation Center of a developing country like Bangladesh.
Method:
: In this study we included ten case of carcinoma of primary lung who have been treated using Radiotherapy. Most of the patients are in stage II or stage IIIA. All patients were treated with Radiotherapy In 3DCRT technique concurrently weekly cisplatin 30mg/m2. All the patients were underwent went 4 modes of CT scan Axial, Helical, Slow & 4D-CT using GE discovery 16 Slice PET-CT scanner. And KV-CBCT for the treatment verification was taken at regular interval. For standardization all the patients underwent different mode of scan using 2.5mm slice thickness and. Slow CT were performed using axial mode scan by increasing the CT tube rotation time as per the breathing period. In 4D-CT scan Respiratory cycle was divided in to 10 phases and scans were performed throughout the entire respiratory cycle. Maxmium Intensity Pixel (MIP), Minimum Intensity Pixel (MinIP) & Average Intensity Pixel (AvIP) were derived from the 10 Phases. GTV or ITV volumes were delineated for all the patients in all the scan modes (ITVAX - Axial, ITVSP - Spiral, ITVSl– Slow, ITVMIP - 4DCT) in the treatment planning system All the GTV or ITV volume were measured, documented and compared with the different modes of the CT scan. We have also done 4 modes of CT scan in moving phantom too. Phantom volume was delineated in all modes of scan (MIP, Slow, Axial and Helical) in treatment planning system and the difference in volume was compared.
Result:
The mean ± sd (range) for MIP, slow, axial, & helical were 36.5 ± 40.5 (2.29-87.0), 35.38 ±39.52 (2.1 – 82), 31.95 ± 37.29 (1.32 – 66.9) & 28.98 ± 33.36 (1.01 – 65.9. Overall underestimate of helical scan and axial scan compared to MIP is 21% and 12.5%. CBCT and slow CT volume has a good correlation with the MIP volume. Ratio of 4DCT and Slow CT scan is 0.97. While we compare volumes (Ratio) of moving phantom of different modes of CT scans, the findings were MIP 50.29cc (1.0), Slow CT 48.83cc (0.97), Axial 35.6 cc (0.71) and Helical 31.68 cc (0.63). Volume comparison in moving phantom also showed good correlation and match in both 4DCT and Slow CT scan. From this study we can draw inference that Slow CT volume has a very good correlation with the MIP volume, the ratio of the Slow CT vs MIP is 0.97 ± 0.12, where as The ratios of GTV(MIP) to GTV (Axial) and GTV(helical) were 0.87 ± 0.14 and 0.79 ± 0.12, respectively, which showed a marked difference in GTV volumes.
Conclusion:
Though, it was limited number of patients in this observational study. But, it showed a very crucial finding to improve the GTV or ITV delineation and to limit the dose to OAR. As slow CT Scan can be done in any CT simulator machine, where there is no facility to do 4DCT scan. Although, 4DCT scan is a gold standard for GTV delineation for the motion management of lung cancer, but, in the absence of 4DCT scan, slow CT can be used. We should need multiple centers, large number of patients’ data to validate this finding
