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Atsuki Uchibori
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EP1.15 - Thymoma/Other Thoracic Malignancies (ID 205)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.15-20 - Good Control by Re-Administration of Carboplatin and Paclitaxel Against Unresectable Thymic Carcinoma (Now Available) (ID 881)
08:00 - 18:00 | Presenting Author(s): Atsuki Uchibori
- Abstract
Background
Many chemotherapy regimens have been administered for unresectable and recurrent thymic carcinoma. However, hightly effective standard regimens have not yet been developed. Although carboplatin-based chemotherapy is considered one of the effective options for thymic carcinoma, carboplatin can be used to treat thymic carcinoma up to only 4–6 cycles following guidelines. In addition, there is no scientific evidence for the usefulness of chemotherapy when thymic carcinoma relapses.
Method
A 48-year-old man who had an abnormal shadow on a chest radiograph obtained during a medical checkup was referred to our hospital. Chest computed tomography (CT) showed a mass measuring 9.3 cm in the anterior mediastinum. Positron emission tomography (PET)-CT showed significant abnormal uptake with a standardized uptake value of 24.5, and there was no evidence of metastasis. We performed median sternotomy, but found pleural dissemination in the right thoracic cavity. We then only obtained a biopsy. Pathologically he was diagnosed with thymic carcinoma. We administered carboplatin and paclitaxel for up to 6 cycles, combined with radiotherapy (60 Gy/30 fr). Six months later, abnormal uptake on PET-CT almost disappeared. However, one year after the chemoradiotherapy, PET-CT showed recurrence of thymic carcinoma. Therefore, we decided to administer the same regimen again for up to 13 cycles.
Result
Conclusion
After re-administration, PET-CT showed markedly decreased accumulation and regression of thymic carcinoma. No severe adverse effects were observed. We have subsequently continued monotherapy containing paclitaxel, and until currently there is no evidence of relapse 23 months after surgery.
Carboplatin has no limitations on its cumulative dose according to its drug package insert, unlike in the case of anthracycline, and the total dose is only limited on the basis of increased side effects regardless of its antineoplasmatic effect. We herein report a case of re-administering carboplatin against unresectable thymic carcinoma beyond the dose suggested by guidelines and achieving good progress.
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EP1.18 - Treatment of Locoregional Disease - NSCLC (ID 208)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Treatment of Locoregional Disease - NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.18-30 - A Case of Resected Primary Lung Cancer with Interlobar Dissemination (Now Available) (ID 1643)
08:00 - 18:00 | Author(s): Atsuki Uchibori
- Abstract
Background
Primary lung cancer with pleural dissemination is at least diagnosed as Stage IVa, and it is considered that there are no surgical indications. This is because the presence of pleural dissemination indicates that the cancer cells exist in the entire pleural cavity, and radical resection is impossible. However, if pleural dissemination is observed in a limited space, we could consider the case as one of locally advanced lung cancer and perform radical resection as an exception of the current staging system.
Method
Result
A 71-year-old man was referred to our hospital because of an abnormal shadow on chest radiography. He was diagnosed with adenocarcinoma of the right upper lobe and cT2aN0M0 stage IB (Union for International Cancer Control (UICC) 8th edition). We planned to perform right upper lobectomy. There were sporadic trabecular adhesions in the right pleural cavity. Although lobulation was relatively favorable, we could not recognize the interlober surface between the upper and middle lobes until after interlobar adhesilolysis. In other words, the interlober space was packed. There were diffuse nodules between the upper and middle lobes suspected of interlobar disseminations. Intraoperative frozen-section diagnosis yielded a pathological diagnosis of pleural dissemination. The pleural effusion cytology showed negative findings. Therefore, we considered the diagnosis to be of locally advanced lung cancer, and upper and middle lobectomy was performed.
Pathologically, the patient was finally diagnosed with papillary invasive adenocarcinoma and pT2aN0M1a Stage IVa (UICC 8th edition), and subsequently, we administered adjuvant chemotherapy, which is in progress.
Conclusion
We performed radical right upper and middle lobectomy for locally advanced lung cancer, which showed interlobar pleural dissemination. This kind of dissemination could be treated like interlobar T3.
