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C.H. Kim



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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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      P1.10-025 - Randomized phase II trial of Safety of Biweekly Docetaxel/Cisplatin vs Gemcitabine/Cisplatin as first-line therapy for advanced non-small cell lung cancer patients who are elderly or poor performance status (ID 1484)

      09:30 - 09:30  |  Author(s): C.H. Kim

      • Abstract

      Background
      Cisplatin with docetaxel (DP) or gemcitabine (GP) is one of standard regimen for advanced non-small cell lung cancer(NSCLC). DP is regarded more toxic compared with GP. There is an increasing interest in a biweekly split administration of DP to reduce its toxicity. Hypothesis here was 1st-line biweekly DP is as safe as GP in elderly or poor performance status (PS) patients (pts).

      Methods
      Chemotherapy naïve pts with NSCLC (IIIB/IV) who were elderly(>65) or poor PS (ECOG 2) were randomized to biweekly DP or GP by balancing for ECOG (0-1 vs 2), stage (IIIB vs IV) and age (<65 vs >65). DP with docetaxel (35mg/m2)/cisplatin(30mg/m2) iv or GP with gemcitabine (1000mg/m2) /cisplatin(30mg/m2) iv was given on days 1,8 every 3 weeks . Chemotherapy lasted upto 6 cycles or until progression. Primary endpoint was safety (proportion of grade 3/4 toxicities). Planned sample size was 49 pts in each.

      Results
      From Nov 2009 to Jan 2013, a total of 97 pts were randomized (DP 50/GP 47). Adenoca was 58% in DP and 51% in GP while that of squamous cell ca 34% in DP and 40% in GP. Stage IIIB/IV was 33%/66% in DP and 42%/59% in GP. In DP a total 228 adverse events (AEs) were reported and 27 were grade 3/4 toxicities while 211 AEs and 21 grade 3/4 toxicities in GP. Neutropenia was the most frequent grade 3/4 toxicity in both (DP 8.9%; GP 15.9%). In DP grade 3/4 leukopenia (8.9%), hyponatremia(6.7%), anemia(4.4%) and anorexia (4.4%) were observed while anemia (9.1%) and hyponatremia (6.8%) in GP. In total AEs, anemia was the most common in both (DP 66.7% ; GP 63.6%). Then, in the following order, hyponatremia (53.3%), anorexia (53.3%) and fatigue(40%) were common in DP while anorexia, (56.8%), fatigue(36.4%) and neutropenia(45.5%) were common in GP. Death during treatment was occurred in 1 pt in each. Both regimen showed similar grade 3/4 toxicities with similar profiles. Survivals seemed to be favorable in GP compared with DP with no statistical significance. Progression-free survivals were 3.72 (DP) and 5.56 (GP) months (p=0.341). Overall survivals were 14.93 (DP) and 20.82 (GP) months (p=0.209).

      Conclusion
      This study showed DP is similar with GP in terms of toxicity and efficacy in treatment of elderly or poor performance patients.

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    P3.07 - Poster Session 3 - Surgery (ID 193)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P3.07-035 - Benefit of preoperative localization using fragmented platinum microcoil for fluoroscopy-aided thoracoscopic resection of solitary pulmonary nodules (ID 2738)

      09:30 - 09:30  |  Author(s): C.H. Kim

      • Abstract

      Background
      Preoperative localization is necessary to perform thoracoscopic resection of small or deeply located solitary pulmonary nodules (SPNs). We recently developed a new localization technique using a self-made, fragmented platinum microcoil, and retrospectively compared the effectiveness of our technique with that of lipiodol.

      Methods
      Fifty two patients underwent thoracoscopic pulmonary wedge resections for 57 SPNs between January 2006 and June 2013. Self-made, fragmented platinum microcoils (Easimarker) were targeted to localize 30 SPNs [17 solid nodules, and 13 ground glass opacities (GGOs)] in 28 patients (Group A), and lipiodol was injected in 27 SPNs (17 solid nodules, and 10 GGOs) of 22 patients (Group B). Preoperative localization using both targeting materials was performed into, or just around the pulmonary lesions on the day of thoracoscopic surgery in the room of chest CT scanner. Localized SPNs were then, wedgely resected using fluoroscopy-aided thoracoscopic surgery (FATS). The intraoperative fluoroscopic exposure (radiation) time, diagnostically detecting rate of pathologic lesions, and other clinical data were collected.

      Results
      Mean size and depth of SPNs in group A and B were 10.6 ± 4.7 mm (range: 0.9 to 23) versus 7.9 ± 4.9 mm (1 to 21), and 10.9 ± 7.9 mm (1 to 30) versus 9.7 ± 8.4mm (1 to 28.2), respectively. CT-guided localizations were successfully performed in both groups. No mortality and major morbidity were observed in both groups. All lesions in both groups were completely resected and diagnosed histopathologically. The intraoperative fluoroscopic exposure time of group A (55.0±40.8 seconds) was significantly shorter than that of group B (105.7±109.0 seconds).

      Conclusion
      Our preoperative localization procedure using fragmented platinum microcoils appears to be effective and feasible in that it has shorter intraoperative time, less radiation exposure, and better accuracy of detecting SPNs. Once inserted fragmented microcoil into the pulmonary lesions stays firmly and more visible radiologically, through lipiodol tends to diperse outside the targeting lesion.