Yukito Ichinose

Multimodal treatment for resectable epithelial type malignant pleural mesothelioma.

BackgroundMalignant pleural mesothelioma is a rare malignancy. The outcome remains poor despite complete surgical resection.Patients and methodsEleven patients with histologicaly proven epithelial type malignant pleural mesothelioma undergoing extrapleural pneumonectomy with systemic chemotherapy and/or radiotherapy before and after surgical resection were retrospectively reviewed.ResultsTen out of 11 patients underwent complete surgical resection, of these 7 patients had stage I disease. Of these 7 patients, 5 are alive without any recurrence, a 2-year survival rate of 80% was observed in this group. There was no operative mortality or morbidity.ConclusionExtrapleural pneumonectomy with perioperative adjuvant treatment is safe and effective procedure for epithelial type malignant pleural mesothelioma.

Cystic brain metastasis of non-small-cell lung cancer successfully controlled with Ommaya reservoir placement

A 68-year-old male presented with hoarseness and anarthria. Computed tomography showed an irregular nodular shadow in the upper lobe of the left lung with swollen multiple lymph nodes. Magnetic resonance imaging revealed a large cystic mass in the left hemisphere of the brain and multiple brain metastases in the bilateral hemispheres. A direct biopsy with bronchoscopy of the pulmonary nodule revealed the tumor to be an adenocarcinoma clinically diagnosed as stage IV. Since the largest brain metastasis continued to grow despite the administration of whole brain irradiation, insertion of an Ommaya reservoir in the cystic lesion was performed. This resulted in a reduction of the size of the brain tumor, and the patient’s neurological symptoms improved. After the Ommaya reservoir was placed, stereotactic radiosurgery was performed on the largest lesion. The patient is doing well at 6xa0months after the Ommaya reservoir was inserted and is currently undergoing chemotherapy. In conclusion, the placement of an Ommaya reservoir may therefore be a potentially useful therapeutic procedure to improve the neurological symptoms and performance status in non-small-cell lung cancer patients with cystic brain metastasis, thereby allowing further neurosurgical therapy and chemotherapy.

Feasibility trial of adjuvant chemotherapy with paclitaxel and carboplatin after surgical resection in Japanese patients with non-small cell lung cancer: report of the Lung Oncology Group in Kyushu (LOGIK) protocol 0501.

AbstractObjectives. The present study was designed to determine whether adjuvant chemotherapy with paclitaxel (TXL) and carboplatin (CBDCA) after surgical resection is feasible in Japanese patients with non-small cell lung cancer (NSCLC) in a multiinstitutional trial.n Methods. From August 2005 to March 2006, 34 patients received the following regimen: TXL (175 mg/m2) and CBDCA (AUC = 5) on day 1, every 3 weeks. The primary endpoint of this trial was the completion rate of four cycles.n Results. The completion rate of four cycles was 79.4% [90% confidence interval (CI), 67.5%-91.3%]. Perfect completion rate of four cycles on schedule and full doses without delay was 50% (90% CI, 34.9%-65.1%). The reasons for incomplete cycles were hypersensitivity to TXL infusion during the first cycle in 3 patients, patients refusal in 2, and anemia and cerebral infarction in 1 patient each. As a consequence of delay and/or dose reductions, the relative dose intensity of TXL and CBDCA was 86.2% and 85.8%, respectively.n Conclusion. Doublet chemotherapy with TXL and CBDCA in the planned doses and schedule was found to be a feasible treatment for Japanese patients following surgical resection for NSCLC.