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F. Barata



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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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      P2.24-057 - Stereotactic Body Radiation Therapy (SBRT) - The success of a new technique in a complex clinical case (ID 3384)

      09:30 - 09:30  |  Author(s): F. Barata

      • Abstract

      Background
      SBRT is an emerging technique, with numerous advantages over classical radiotherapy, namely in high surgical risk patients.

      Methods
      Critical review of a clinical case

      Results
      The authors report the case of a 37 year-old man, type 1 Neurofibromatosis patient, with dorsal paraplegia secondary to paravertebral tumours, severe kiphoscoliosis, and chronic hypercapnic respiratory failure requiring continuous non-invasive ventilation (NIV) since 2007. He was also medicated with Baclofen 125mg/day and botulinum toxin for severe spasticity, with poor response. In May 2010, he was diagnosed with testicular malignancy, which has undergone radical resection under local anaesthesia. In June 2010 he was submitted to a follow-up CT scan, which revealed a 9mm pulmonary nodule on the right upper lobe that remained under supervision, due to the risks of invasive diagnostic procedures. In January 2012, because of a significant size increase, a CT scan-guided biopsy of the lesion was performed, which revealed a lymphoepithelioma-like carcinoma. Subsequent CT-scans demonstrated progressive growth of the neoformation (4.9cm in July 2012) with invasion of the thoracic wall, and the PET/CT scan revealed FDG-F18 hyper fixation. Due to the comorbidities, and the need for continuous NIV, he had no surgical, chemotherapy or classical radiotherapy conditions. The remaining treatment option was SBRT. Therefore, a planning 4D-CT scan with a vacuum mattress for immobilization was performed, and a therapy plan was defined to deliver a total dose of 48Gy, in four fractions of 12Gy, in alternate days, with support of Image-Guided Radiation Therapy (IGRT) technology. There was a good clinical and haematological tolerance, no acute or late complications were referred, and the 6 months follow-up CT-scans showed partial response, according to RECIST criteria.

      Conclusion
      SBRT is nowadays a valid alternative for lung cancer treatment in patients with medical contraindications to surgical treatment, demonstrating a high local control of the lesion, associated with low toxicity effects. Figure 1Figure 2

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    P3.22 - Poster Session 3 - Epidemiology, Etiology (ID 168)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Prevention & Epidemiology
    • Presentations: 1
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      P3.22-010 - Advanced Non-Small Cell Lung Cancer (NSCLC-AD) in patients under 50 - a new reality (ID 3404)

      09:30 - 09:30  |  Author(s): F. Barata

      • Abstract

      Background
      The incidence of NSCLC in young patients increases annually. Our objective is to characterize this specific population

      Methods
      Retrospective study of 61 consecutive NSCLC-AD cases in patients under 50 years old, diagnosed between 2001 and 2011. Clinical data, histology, Performance Status (PS), therapy and overall survival (OS) were evaluated.

      Results
      Of all the patients 70.5% were men, mean age 44.7 ± 4.12 years, most of them smokers (55.7%) with a Performance Status (PS) of 1 (83.6%), 2 (9.8%) or 3 (6.6%). Comorbidities were found in 42.6% of patients. The most frequent histology was adenocarcinoma (55.7%) followed by squamous cell (39.4%) and large cell (4.9%). Metastasis in 1, 2 or 3 organs were found in 49.2%, 27.9% and 22.9% respectively. Excluding two patients that are still alive (49.5 and 65.3 months after initial diagnosis), the global OS was 12.4 months. All patients with PS 3 were smokers with comorbidities, had more than 2 sites of metastization and underwent best supportive care only. Mean OS of this group was 0.7 months. Only 1 patient with PS 2 showed comorbidities and they were all submitted to 1[st] line chemotherapy with "platinum-based doublets". No 2[nd] line therapy was initiated and mean OS of this group was 4.7 months. In the PS 1 group (51 patients), 43.1% showed at least 1 comorbidity and 56.9% had >1 metastasized organ. The mean OS of this group was 10.8 months. All patients underwent 1[st] line chemotherapy – options were "platinum-based doublets" (50 patients) and Erlotinib (1 patient). Second line therapy was done in 60.8% (31) of these patients (Pemetrexed in 14 patients, Docetaxel in 11 patients and Erlotinib in 6 patients), and 3[rd] line in 35.5% (11) – options were Erlotinib (9 patients), Pemetrexed and Carboplantin+Vinorelbine (1 patient each). Two patients started 4[th] line therapy (3.9%) with Pemetrexed. OS for different therapeutic lines in this group (patients that underwent only one line of therapy, 2 lines or 3 lines) were respectively 5.8 months, 11.45 months and 29.2 months.

      Conclusion
      In our study, young patients with NSCLC present in advanced stages with important comorbidities and have an overall prognosis similar to the literature. Stronger physical reserve may allow several therapeutic lines to be completed in a significant number of cases.