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L. Petruzelka



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    P1.10 - Poster Session 1 - Chemotherapy (ID 204)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.10-022 - Central European Initiative against Lung Cancer: Results of the Inaugural Workshop (ID 1401)

      09:30 - 09:30  |  Author(s): L. Petruzelka

      • Abstract

      Background
      Lung cancer is a major health problem in Central Europe where some of the countries have the world-wide highest incidence rates of this cancer. The CENTRAL EUROPEAN INITIATIVE AGAINST LUNG CANCER aims at decreasing the burden of lung cancer in this region. The Inaugural Workshop of this Initiative was planned in order develop strategies to achieve this goal.

      Methods
      Participation at the Workshop was by invitation and more than 100 lung cancer experts from several Central European Countries and Israel did participate. The participants discussed the current status of lung cancer management and suggested strategies for improvement in the various areas of lung cancer management.

      Results
      The Workshop focused on all aspects of lung cancer. There was agreement that lung cancer is a major health problem in all Central European countries and that improvement in all aspects of lung cancer management must be attempted. Prevention strategies have steadily been improved but remain insufficient in most countries. The potential of screening was recognized but routine implementation of screening was not considered to be feasible in most Central European countries at this time. Access to modern radiological imaging such as PET-CT must be improved in many centers. A future project will assess the accuracy of radiological staging in several hospitals. Molecular diagnosis is increasingly implemented in most countries but patient selection for molecular analyses varies between countries. A major area of discussion was the implementation of standard treatments. Multidisciplinary tumor boards have been established in most centers but participants disagreed on whether all or only selected patients should be presented during tumor board meetings. Concerning stage III NSCLC, great heterogeneity with regard to both staging and treatment has been recognized. A future project plans to assess current management of patients with stage III NSCLC and to define areas for improvement. Access to systemic treatment has improved over the years but timely access to novel and expensive drugs remains challenging in several countries. Strategies to increase the scientific co-operation and education have also been discussed and should increasingly be implemented in the future.

      Conclusion
      The Workshop did outline the current status including challenges in the management of patients with lung cancer in Central Europe. Next projects will assess staging accuracy and detailed treatment of patients with locally advanced NSCLC. Future events such as the 14th Central European Lung Cancer Congress in 2014 and the 17th World Congress on Lung Cancer in 2016 in Vienna should also have a major impact on decreasing the burden of lung cancer in Central European countries.

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    P2.24 - Poster Session 2 - Supportive Care (ID 157)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P2.24-027 - Cisplatin plus pemetrexed and concurrent radiation with consecutive surgery in locally advanced adenocarcinoma of the right lung - case report (ID 1642)

      09:30 - 09:30  |  Author(s): L. Petruzelka

      • Abstract

      Background
      Locally advanced non-small cell lung cancer has poor prognosis with less than 20% probability of 5-year survival despite the use of concurrent chemoradiotherapy. Last generation chemotherapy regimen, high dose of radiotherapy, and surgery if feasible are options to achieve better outcomes in highly selected cases.

      Methods
      A case report of a 25-year woman with non-mutated adenocarcinoma of the right lung is presented in this work.

      Results
      The young woman, age 25 years, smoker of 1 pack/day since the age of 18 years, without family cancer history presented with right lung perihilar mass. CT scan showed tumor infiltration of the right upper lobe of 73x65x80 mm involving mediastinum as well as enlargement of right hilar and mediastinal lymph nodes. Suspicion of left aortic arc lymph nodes infiltration was described on FDG-PET/CT but no distant metastases were seen. Transbronchial biopsy confirmed adenocarcinoma. EGFR mutation and ALK translocation were not found. TNM stage (UICC7) was T4N2-3M0 – clinical stage IIIB. Performance status 1, cough, dyspnoea and mild weight loss at time of diagnosis were noted. Treatment consisted of 5 cycles of chemotherapy with cisplatin and pemetrexed in standard doses every 3 weeks and concurrent radiotherapy given in the dose of 72Gy/36 fraction/7.5 weeks during 3-5th cycle. Restaging after CRT showed substantial partial remission with negative mediastinal lymph nodes on PET/CT scan, therefore surgery was proposed, resulting in right upper lobectomy and mediastinal lymphadenectomy. The histology showed residual adenocarcinoma 35x20x45mm with regressive signs, stage ypT2 ypN0. Whole-body and brain FDG-PET/CT two months after surgery confirmed complete remission. No additional chemotherapy nor prophylactic cranial irradiation were indicated but close follow-up has been planned because of the high risk of recurrent distant metastases.

      Conclusion
      This case report showed successful multimodal therapy of advanced NSCLC in a very young woman whose age and good PS warranted aggressive treatment approach. This abstract was supported by a grant from the Ministry of Health of the Czech Republic – IGA MZ CR NT12331-5/2011 and by a grant from the Charles University Prague PRVOUK - P27.