Lung Cancer

A randomized control trial to study the efficacy of time dependent versus volume dependent chest drain removal protocol for talc slurry pleurodesis in patients with malignant pleural effusion Sarah Ann Koshy, Richa Gupta, Prince James, Ashwin Oliver Department of Respiratory Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. E-mail: [email protected] Background: Chemical pleurodesis helps in preventing reaccumulation of pleural fluid and alleviates the dyspnea in patients with malignant pleural effusion. As patients with terminal disease are anxious to stay for prolonged duration in hospital, rapid pleurodesis helps in shorter hospital stay with effective pleurodesis and less hospital acquired complications. Aim: To study the efficacy of time dependent versus volume dependent(<150ml/day) chest drain removal protocol for TALC slurry pleurodesis in patients with malignant pleural effusion. Methods: All patients with biopsy/cytology proven malignant pleural effusion were recruited into the study. After talc slurry pleurodesis, they underwent randomization into short or standard chest tube removal protocol after lung expansion is confirmed. The success of pleurodesis was followed up at the end of 7 days, 1 month and 3 months by radiological or clinical questionnaire. Results: 72 patients with malignant pleural effusion were enrolled in the study and followed at pre-set time intervals in either arm. There was no significant statistical difference between both the arm with regards to success of pleurodesis after 1 week, 1 month and 3 months. There was significant statistical difference in time needed from pleurodesis to ICD removal between both groups, which translated into significant difference between chest drain free days for patients among the two groups. Mortality or complications were not statistically different in either arm. Conclusions: From our study, shorter term pleurodesis is safe and equivalent when compared to the standard protocol with no difference between recurrence of pleural effusion post talc slurry pleurodesis. A rare case of mediastinal yolk sac tumor Kohena Roy, Abhishek Dey, Sukanta Kodali, Joydeep Deb Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India. E-mail: [email protected] Background: Mediastinal Germ Cell Tumors are extragonadal germ cell tumors (EGGCTS) commonly seen in children and young adults. They are more common in men. Clinically they are classified as teratomas, seminomas and non-seminomatous germ cell tumors. Primary mediastinal germ cell neoplasm is an extremely rare tumor (50-70% of all extragonadal germ cell tumors). Case Study: In this case, an 18 years old boy presented with cough and dyspnea from last 1 year and swelling of face and neck from last 3 months. CECT thorax shows a large heterogenous anterior mediastinal mass invading SVC. His serum alpha feto protein was raised and trucut biopsy report suggest malignant germ cell tumor favoring yolk sac tumor. Discussion: Extra gonadal primary GCT account for 1% to 5% is the most common site, constituting 50% to 70% of all extra gonadal GCT. These tumors probably derivate from fail in migration of primitive germ cell that migrate through urogenital crest during embryogenesis to develop regular function and hematological transport formation. Conclusion: Primary yolk sac tumor has poor prognosis despite advances in therapy with surgical resection and cisplatin based chemotherapy. This poor prognosis is due to degree of invasion and unresectibility in most patients by time of diagnosis. Prospective study on changes in lung function of patients receiving chemotherapy and radiotherapy for nonsmall cell carcinoma (stage 3 and stage 4) Rennis Davis, Nirmal Varghese Mathew Department of Respiratory Medicine, Amala, Kerala, India. E-mail: [email protected] Background: Non small cell lung cancer represents majority of lung cancer and most of these cases will be in an advanced stage at the time of presentation. Chemotherapy with radiotherapy is the treatment of choice in stage 3 and 4 Non small cell carcinoma( NSCLC). Pulmonary toxicities has been reported with both modalities of treatment. Pulmonary toxicitypresented at a median of 63 days after the start of combined modality therapy. Reduction in DLCO has strong correlation with grade of pneumonitis. When DLCO is below the predicted reference range it becomes a clue to the presence of a physiologic problem that can even affect long-term survival. Objectives: 1. To compare pre and post treatment spirometry including DLCO to assess the effect of chemoradiation/ chemotherapy. 2. To evaluate the effects of patient factors ( age, smoking habits, comorbidities)and tumor factors(size,location) to changes in pulmonary function. Methods: This is a descriptive cohort study, over a period of 18 months with 56 non small cell lung cancer patients of stage 3 and 4 selected and divided into chemotherapy and chemoradiation group depending on the treatment with DLCO was and after treatment in both groups. The difference of lung function in different treatment group was by and were to evaluate the effects of standard patient factors age, smoking habits, tumor Results: the 56 study were and were The was with a standard of in chemotherapy and in chemoradiation In chemotherapy no correlation was with and pulmonary function changes in pre and post treatment. was to an effect on pre treatment and post treatment DLCO ( and with pre and post treatment of and When and with pulmonary function changes were in and non it was that DLCO changes of pre treatment and post treatment. In an effect on DLCO for pre and post treatment with and and on ( pre and post treatment with and In chemoradiation group the of the that is and when effect on pre and post treatment DLCO with in pre treatment group and in post treatment DLCO and among chemotherapy and chemoradiation group and post is to be in chemoradiation group with DLCO were in both group with post treatment with of is in Conclusion: In our study the lung cancer patients a of patient to The chemoradiation group more changes in pulmonary function as compared to chemotherapy are to be in chemoradiation This can be by changes by DLCO was in both more in chemoradiation to be in chemoradiation due to in after most is DLCO in lung function with tumor is to into of lung of the study the that of our patients develop correlation of DLCO with and correlation between and were not to short duration our study not as to the changes in pulmonary function are or Pulmonary with and A case study India. E-mail: [email protected] Background: Pulmonary an of and for of lung it as chest mass with and it in Case Study: A was presented to the Department a After with a chest was which an of on The a and on in a in the tumor. to was at a This to the of pulmonary and in the patient to in the The was and in Discussion: Pulmonary at a rapid a short rapid and to be during the advanced surgical treatment is the that to be The treatment be by a of an a a and a This treatment be by chemotherapy or Conclusion: This pulmonary neoplasm be with and radiotherapy with and tumor from A case Department of Respiratory Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. E-mail: [email protected] Background: is a rare of the into a a it can be for an and in therapy. This case the clinical of patients with to an primary carcinoma of the Case This case 3 patients between to with a primary carcinoma of the were to of into Discussion: There are with that can be seen on and the presence of the of expansion and the can between the two when is due to of both the and The between the two by radiological to and of Conclusion: can in in the is the for both and in of the can and in with a short pleural A rare of pleural effusion in Department of Pulmonary and Medicine, Medical India. E-mail: [email protected] Background: pleural is the most common primary pleural which from of the pleural common is which is seen in of cases are Case Study: 56 year old a presented with of of chest and for 3 months. There was no of clinical was to pleural effusion with pleural fluid was of with and report for was followed by pleural which on pleural and on of The biopsy was for pleural Discussion: of reported from India. seen in as they are more to be to and they can in the median is is to the with as is to has a poor prognosis with a median of months diagnosis. Conclusion: is in and in non of and pleural biopsy is to to invasion and Primary pleural extremely rare Department of Pulmonary Medicine, Medical India. E-mail: [email protected] Background: are a group of tumors. In primary pleural is an extremely rare tumor. has and Case report a case of old presented with a of of and chest a of the with a mediastinal the and a mass in the pleural with pleural effusion. biopsy cell and and were for and primary lung with and a of primary pleural was was with chemotherapy and radiotherapy due to the of the tumor. Conclusion: Primary pleural is a rare and tumor. it is it be in the of lung and pleural and are for the of diagnosis. A study of pleurodesis and in patients with malignant pleural effusion Department of Respiratory Medicine, Medical College and Hospital, Tamil Nadu, India. E-mail: [email protected] Background: pleural effusion significant in the of The recurrence of effusion can be by pleurodesis. The of this study is to compare the efficacy and complications of pleurodesis and in patients with Methods: patients with malignant pleural effusion were in the study. They were divided into two groups. group has A were to pleurodesis and group were to pleurodesis. All the patients were during the in hospital post pleurodesis and after of pleurodesis. Results: of with and with group after of pleurodesis. This was statistically significant of our patients complications and no complications followed by pleurodesis. of the patients chest and Conclusion: pleurodesis is ple

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