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Rashmey Pun



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    P1.14 - Thymoma/Other Thoracic Malignancies (Not CME Accredited Session) (ID 946)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 2
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.14-23 - Thymoma: An Epidemiological and Clinico-Pathological Profile in Nepalese Population. (ID 13774)

      16:45 - 18:00  |  Author(s): Rashmey Pun

      • Abstract
      • Slides

      Background

      Thymomas and thymic carcinomas are most common tumor of anterior mediastinum representing 0.5 % to 1.5% of all the malignancies. Surgery is the main stay of treatment with adjuvant radiation recommended for the invasive thymomas. It accounts for 0.1% of all the malignancies as per National Cancer Registry Nepal. Because of the rarity of the tumor we aim to review the profile of patient with thymic tumor in our patient population.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      All the patient with diagnosis of thymoma attending the Department of Clinical oncology, National Academy of Medical Sciences (NAMS), Bir Hospital, Nepal during 2009 -2015 was evaluated. We reviewed the record of all registered, histologically diagnosed thymoma and thymic carcinomas and are presented in this study.

      4c3880bb027f159e801041b1021e88e8 Result

      Total of 51 record with thymoma and thymic carcinomas were reviewed out of which 71% (36) patient were male. The mean age was 46.99 years with youngest being 18 years and the eldest 70 years of age. Most common presenting symptom was shortness of breath (37%), followed by cough (23%0, generalized weakness (14%), dysphagia (14%) and drooping of eyelid (12%). About 29.41% of patient was diagnosed with myasthenia gravis. 14% of patients were diagnosed on stage II, 57% on stage III and 29% with stage IV (modified Masaoka clinical stage). WHO pathological stage B 39%(20) [(B1-12%(6), B2-18%(9), B3-10%(5)] was most common, with A 24%(12), AB 20%(10), and C 18%(9). 11% of patient underwent upfront surgery. Neoadjuvant therapy was offered for 63%(32) with 68.75%(22) resectability rate. 27% were eligible only for palliative treatment. About 95% patient received chemotherapy and 90.19% patient received radiation therapy either curative or palliative. 62.74% received curative radiation. 62.74% (32) patients are still on regular follow up with no signs of relapse.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Multimodality therapy remains the main stay of treatment for thymomas rendering the disease curative. Significant number of patient received neoadjuvant chemotherapy therapy followed by surgery and adjuvant radiation therapy. WHO Type B seems to be more frequent type. Thymoma is quite often associated with myasthenia gravis without adverse effect on prognosis. However, in view of limited study due to rarity of the disease various aspects yet to be explored.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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      P1.14-24 - External Radiotherapy Concurrent with Cisplatin Plus 5- Flurouracil in Locally Advanced Carcinoma of Esophagus (ID 13795)

      16:45 - 18:00  |  Presenting Author(s): Rashmey Pun

      • Abstract
      • Slides

      Background

      Esophageal cancer is the eighth most common cancer in the world with the high rates of local recurrence and metastasis. As per the data of National Cancer Registry Nepal it ranks among the top ten cancers with 2.6% prevalence. Definitive concurrent chemo radiotherapy (CCRT) is the standard for the non surgery patients, and the use of Cisplatin with 5-Flurouracil is the common chemotherapy regimen.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A prospective and comparative study was undertaken from 2014-2015 to evaluate the effect of CCRT in patients with locally advanced carcinoma of esophagus in our patient population.The eligibilty criteria included locally advanced, ECOG score of <2. Patients received chemo radiotherapy (50Gy / 25fractions) and Cisplatin 75mg/m2 on Day 1 and 5-Flurouracil 1000mg/m2 on Day 1- Day 4 every 4 weeks apart on weeks 1 and 5. Radiation only group received 64 Gy/33 fractions.

      4c3880bb027f159e801041b1021e88e8 Result

      40 patients were enrolled in the study. Among these patients 65.0% were male and the disease was prevalent at 55-64 years age group. 72.5% of the patients were smokers, 55.0% were alcohol consumers and 20.0% were Tobacco chewers. The most common site of the primary tumor was the mid thoracic region of the esophgus consisting of 62.5%. The combined modality of treatment was toxic but managable with supportive care. Thre were 4 drop outs, 1 from CCRT group and 3 from Radiation (RT) alone group due to the progression of the disease. 65.0% attained partial response and 25.0% achieved complete response in the CCRT group which was in favor of CCRT in comarison to the RTalone group.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Concurrent chemoradiotherapy yields high locoregional control, in comparison to radiotherapy alone in patients with locally advanced esophgeal carcinoma. Definitive chemoradiotherapy has shown promising results and appears to be superior to RT alone as the sole modality of treatment. Cisplatin and 5-Flurouracil concurrently with radiation therapy is economical alternative with tolerable toxicity profile in resource constraint settings like ours.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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