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D.T. Beyer
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-021 - Radionuclide Therapy with Meta-Iodo-Benzyl-Guanidine (MIBG) for Patients with MIBG Avid Pulmonary Carcinoid Tumors (ID 3114)
09:30 - 09:30 | Author(s): D.T. Beyer
- Abstract
Background:
Pulmonary carcinoid tumors represent only 2% of all lung tumors. Treatment generally involves surgery which many times is curative, however, once metastasis develops there are no standard treatment options. Radionuclide therapy with MIBG has been shown to be beneficial for gastroenteropancreatic neuroendocrine tumors. We sought to determine the efficacy of MIBG treatment for metastatic pulmonary carcinoid tumors at the Ochsner/Louisiana State University Neuroendocrine Program.
Methods:
All patients who had a diagnosis of a metastatic typical or atypical pulmonary carcinoid tumor and who underwent MIBG treatment at our institution were included. Tumor characteristics, demographic information, response rate and survival was captured. Patients without adequate records were excluded. All patients required MIBG avid disease on MIBG scintigraphy. MIBG treatment consisted on 200 mCi of [131]I MIBG delivered over one hour at 30 cc/hour. Follow up CT scans were used to determine response by RECIST 1.1.
Results:
Six pulmonary carcinoid patients were identified who had undergone MIBG treatment. The mean age at initial MIBG treatment was 66 (range 44-89) Females represented 83% of patients. There were five typical and one atypical carcinoid patient included. Two patients achieved a partial response, one patient had stable disease and three patients had progression following MIBG treatment. Overall survival for the entire cohort from the date of MIBG therapy is shown. Figure 1
Conclusion:
In our small cohort, MIBG treatment seemed to be beneficial in 50% of patients with MIBG avid disease with a partial response observed in 33% of patients. This treatment was well tolerated and offered an increased survival in an already heavily pretreated cohort. MIBG may offer some pulmonary carcinoid patients an additional treatment option. Further research should be directed at examining radionuclide therapy in pulmonary carcinoid patients.
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P3.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 226)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.08-018 - Clinical and Pathologic Characteristics of Bronchial Carcinoid Tumors: A Single Institution Review (ID 2858)
09:30 - 09:30 | Author(s): D.T. Beyer
- Abstract
Background:
Typical and atypical carcinoids represent about 2% of all lung tumors. Unlike most lung tumors, survival of patients with typical bronchial carcinoids is generally long but and is dependent on stage. We report the findings from the Ochsner/Louisiana State University (LSU) Neuroendocrine Tumor (NET) Program.
Methods:
A database with all patients who were seen at the Ochsner/LSU NET Program was queried for all bronchial NET patients. We included those who had confirmed pathological bronchial carcinoid and those who had at least one visit to our clinic. Typical and atypical bronchial carcinoids were defined by most recent WHO classification. Excluded were patients with large and small cell NETs, diffuse idiopathic pulmonary neuroendocrine cell hyperplasia, and inaccessible patient records.
Results:
One-hundred sixty-nine patients were included from January 1996 - March 2015. The mean age at diagnosis was 53 (range 12-92). There were 154 (91%) Caucasian, 10 (6%) African-American, and 5 (3%) other. Females represented 67% of all patients. 51% percent (86/169) were well differentiated, 12% (21/169) were moderately differentiated. Eighty-five percent and fifty-three percent were positive on PET and octreotide scanning, respectively. One-hundred fifty-five patients had adequate staging information. Overall survival and survival by stage and differentiation status is shown below. There was a statistically significant difference in survival by Ki-67 index.
* A and B stages are grouped Figure 1Overall Survival N Median 5-year 10-year 169 243 months 88% 74% Survival by AJCC 7 Stage N 5-year 10-year I* 65 98% 91% II* 23 95% 87% III* 27 84% 66% IV 40 73% 49% Survival by Differentiation Status Median 5-year 10-year Well (n=86) 243 88% 81% Moderate (n=21) 119 80% 42% Survival by Typical/Atypical Median 5-year 10-year Typical (n=109) 243 months 89% 80% Atypical (46) 126 months 84% 59%
Conclusion:
Overall, patients with bronchial carcinoids experience high 5 and 10-year survival rates. As expected, there were significant survival differences between nodal status, differentiation status and typical versus atypical. Interestingly, there was a statistically significant difference in survival between low, low-intermediate and high-intermediate Ki-67 values. Our analysis showed that survival rates were much better for Ki-67 index value ranges from 0-2% versus >2-10% versus >10-20%. As with gastroenteropancreatic NETs, Ki-67 index could become a valuable prognostic indicator for bronchial carcinoids.
