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Lung Cancer. 2014 Nov;86(2):241-6. doi: 10.1016/j.lungcan.2014.08.012. Epub 2014 Aug 27.

Chemotherapy for locally advanced and metastatic pulmonary carcinoid tumors.

Author information

1
Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, United States.
2
Massachusetts General Hospital Cancer Center, 55 Fruit Street, Boston, MA 02114, United States.
3
Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215, United States.
4
Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215, United States.
5
Department of Pathology, Brigham and Women's Hospital, Boston, MA 02215, United States.
6
Center for Gastrointestinal Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, United States.
7
Division of Thoracic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02215, United States.
8
Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, United States; Belfer Institute for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA 02215, United States.
9
Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, United States. Electronic address: Bruce_Johnson@dfci.harvard.edu.

Abstract

OBJECTIVES:

The optimal management of locally advanced and metastatic pulmonary carcinoid tumors remains to be determined.

MATERIALS AND METHODS:

A retrospective review was conducted on patients with typical and atypical pulmonary carcinoid tumors treated at our institutions between 1990 and 2012.

RESULTS:

300 patients were identified with pulmonary carcinoid, (80 patients with atypical carcinoid), of whom 29 presented with metastatic disease (16 atypical). Of evaluable patients, 26 (41%) with stages I-III atypical carcinoid tumors recurred at a median time of 3.7 years (range, 0.4-32), compared to 3 (1%) patients with typical carcinoid (range, 8-12.3). 39 patients were treated with chemotherapy, including 30 patients with metastatic disease (27 atypical), and 7 patients were treated with adjuvant platinum-etoposide chemoradiation (6 atypical, 1 typical, 6 stage IIIA, 1 stage IIB). At a median follow-up of 2 years there were 2 recurrences in the 7 patients receiving adjuvant treatment. Median survival after diagnosis of metastatic disease for patients with atypical pulmonary carcinoid was 3.3 years with a 5-year survival of 24%. Treatment regimens showing efficacy in pulmonary carcinoid include 15 patients treated with octreotide-based therapies (10% response rate (RR), 70% disease control rate (DCR), 15 month median progression-free survival (PFS)), 13 patients treated with etoposide+platinum (23% RR, 69% DCR, 7 month median PFS), and 14 patients treated with temozolomide-based therapies (14% RR, 57% DCR, 10 month median PFS). 8 of 10 patients with octreotide-avid disease treated with an octreotide-based regimen experienced disease control (1 partial response, 7 stable disease) for a median of 18 months (range 6-72 months).

CONCLUSIONS:

These results support our previous finding that a subset of pulmonary carcinoid tumors are responsive to chemotherapy.

KEYWORDS:

Atypical carcinoid; DIPNECH; Typical carcinoid

PMID:
25218177
PMCID:
PMC4293119
DOI:
10.1016/j.lungcan.2014.08.012
[Indexed for MEDLINE]
Free PMC Article

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