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Hidetoshi Inokawa



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    P2.06 - Mesothelioma (Not CME Accredited Session) (ID 955)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.06-27 - Extrapleural Pneumonectomy, Radiation Therapy, and Chemotherapy for Epithelioid Malignant Pleural Mesothelioma (ID 11786)

      16:45 - 18:00  |  Author(s): Hidetoshi Inokawa

      • Abstract
      • Slides

      Background

      The treatment strategy for malignant pleural mesothelioma (MPM) has not been established yet. Our improving results of trimodality therapy with extrapleural pneumonectomy (EPP), radiation therapy, and chemotherapy for epithelioid MPM are reported.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Twenty four consecutive EPP for epithelioid MPM which were performed from February 2011 to August 2017 in our hospital were reviewed. We have instituted a trimodality therapy protocol consisting of EPP, adjuvant 45-50.4 Gy hemithoracic radiation therapy, and adjuvant CDDP plus PEM chemotherapy. 20 patients have been treated with this protocol. However, 4 patients were given induction CDDP plus PEM chemotherapy, and referred to us. They were scheduled to undergo EPP and adjuvant hemithoracic radiation therapy. Overall survival was calculated from the start of treatment using Kaplan-Meier method. This was one institutional retrospective study.

      4c3880bb027f159e801041b1021e88e8 Result

      Median age at EPP was 60 (39 - 69) years old. Female was 8, and male was 16. Right side was 14, and left side was 10. Median EPP time was 7 hours 3 minutes (5 h 52 m – 8 h 56 m). No blood transfusion during EPP was 10 cases (42%). 30 day mortality was zero. Atrial fibrillation was the most common morbidity, and developed in 12 patients (50%). IMIG pathological stage was stage IV in 2, stage III in 13, stage II in 5, and stage Ib in 4. Adjuvant 45-50.4 Gy radiation therapy was completed for 21 patients (88%). 4 patients (17%) could not undergo chemotherapy. 18 patients (75%) underwent trimodality therapy. Postoperative median follow-up period was 4 years. Five year survival, two year survival, and median survival were 41%, 66%, and 40 months.

      wclc2018epp.jpg

      8eea62084ca7e541d918e823422bd82e Conclusion

      This trimodality treatment strategy with EPP, hemithoracic radiation, and chemotherapy for epithelioid MPM is feasible. Although many advanced cases were treated, the prognosis has been greatly improved.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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