Author of

• 31322

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  P2.11 - Screening and Early Detection (ID 178)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Screening and Early Detection
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31372

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    P2.11-43 - Management of Pulmonary Nodules Detected on CT: Multicenter Collaborative Study in Nagasaki Prefecture (ID 1774)

    10:15 - 18:15  |  Author(s): Hiroshi Mukae
    • Abstract
    • Slides

    Background
    

    Pulmonary nodules are frequently detected on low-dose CT screening of the chest. Most of them are benign and lung cancer is only a part, so handling of pulmonary nodules is a major issue. Although the guidelines of the Japanese Society of CT Screening have been published, the examination of their usefulness is not sufficient. Therefore, the pulmonary nodules detected on CT were handled according to the guideline (version 2), and the clinical significance and the usefulness of the guideline were examined.

    Method
    

    Pulmonary nodules with 5mm or larger in size on initial chest CT were followed up prospectively at five facilities in Nagasaki Prefecture. CT Images and clinical data were collected in one center, and analysis was performed on the same workstation (Aquarius Net Station ver. 1.5). In the central review, measurement at the workstation and evaluation of visual characteristics of the nodules were performed by two or more experienced radiologists, and the results were returned to the participating facilities to be reflected in the handling and follow-up of the nodules.

    Result
    

    131 cases were registered in total, 39 cases were excluded and the remaining 92 cases were analyzed (57 women, 35 men, average age 65.6 (39-87) years old). 39 cases were solid nodule, 17 cases were part solid ground-glass nodule (GGN) and 36 cases were pure GGN. 20 cases were surgically resected, and histological findings were obtained for 17 nodules: 14 adenocarciomas (two solid nodules, 7 part solid GGNs and 5 pure GGNs), two squamous cell carcinomas (two solid nodules), one lung metastasis (solid nodule). Fifteen cases shrank or disappeared overtime (7 solid nodules, 4 part solid GGNs and 4 pure GGNs). Twenty-four month follow-up was completed in 57 cases (27 solid nodules, 3 part solid GGNs and 27 pure GGNs).

    Conclusion
    

    Although handling of pulmonary nodules detected on chest CT was conventionally left to the discretion of the institution /in-charge doctor, using this guideline made the policy of clearer and became possible to evaluate the natural history of pulmonary nodules correctly. There were no cases that became inoperable due to the appearance of distant metastasis during follow-up, and this guideline was considered appropriate.

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• 31401

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  P2.12 - Small Cell Lung Cancer/NET (ID 180)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Small Cell Lung Cancer/NET
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31408

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    P2.12-07 - Phase I Study of Amrubicin and Cisplatin with Concurrent Thoracic Radiotherapy (TRT) in Limited-Disease Small Cell Lung Cancer (LD-SCLC) (ID 47)

    10:15 - 18:15  |  Author(s): Hiroshi Mukae
    • Abstract

    Background
    

    Amrubicin and cisplatin is one of active regimens for patients with extensive-disease small cell lung cancer (ED-SCLC). Combined modality of combination chemotherapy and concurrent thoracic radiotherapy has been recognized as standard treatment for LD-SCLC. This study aimed to determine the maximum tolerated dose (MTD), and dose limiting toxicity (DLT) of amrubicin and cisplatin with concurrent TRT in LD-SCLC.

    Method
    

    Patients fulfilling the following eligibility criteria were enrolled: chemotherapy-naïve, PS0-1, age =<75, LD-SCLC, and adequate organ function. Patients received escalating doses of amrubicin on days 1, 2, and 3, under a fixed 60 mg/m² of cisplatin on day 1. Four cycles of chemotherapy were repeated every 4 weeks. TRT of once-daily 2Gy/day commenced on day 2 of the first cycle of chemotherapy. The initial doses of amrubicin was 20 mg/m² (level 1), and the dose was escalated to 25 (level 2) and 30 (level 3) mg/m².

    Result
    

    Eight patients were enrolled at three dose levels. male/female=3/5; PS 0/1=4/4; median age (range) =68.5 (60-73). Two of two in level 3 experienced DLTs. The presentation of DLTs was grade4 neutropenia and leukopenia lasting more than four days. The MTD determined level 3, and level 2 was recommended for this combined modality. Evaluation of responses were 7 partial response and 1 progressive disease (response rate 87.5%) and the median overall survival time was 24.7 months, and suggested the regimen seemed to be modest activity.

    Conclusion
    

    In combined modality of this chemotherapy with TRT for LD-SCLC, MTD was amrubicin 30 mg/m² and cisplatin 60 mg/m², and DLTs were neutropenia and leukemia.