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Mesothelioma (NCI) PowerPoint Presentation

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Mesothelioma (NCI) Presentation Transcript

Slide 1 - Case 1 FME 45 ys old female housewife from Helwan. At presentation ( 8/10/2003), she was complaining of pain in the chest and dyspnea of 4 month duration. CT chest revealed right pleural effusion associated with complete collapse of the middle and lower right lung lobes,enlarged mediastinal lymph node. Pleural biopsy: malignant mesothelioma mixed type
Slide 2 - Received Pemetrexed plus Cisplatin for 6cycles started in 17/11/2003 every 21 days. CT evaluation after 2nd cycle showed partial remission. At the end of treatment : Still partial remission , duration of response more than 17 months. Toxicity: vomiting grade I, edema
Slide 3 - Pretreatment + + F M E After 2 cycles
Slide 4 - + Pretreatment After 2 cycles F M E +
Slide 5 - Case 2 AMM 40 ys old female housewife from Giza. At presentation ( 8/11/2003), she was complaining of cough and dyspnea of 3 month duration. CT chest revealed: right pleural thickening and effusion. Multiple small hepatic focal lesions. Thoracoscopic Pleural biopsy: malignant mesothelioma epithelial type, low grade.
Slide 6 - Received Pemetrexed plus Cisplatin for 6 cycles started in 7/12/2003 ended in 19/4/2004. CT evaluation after 4 cycles (21/03/2004) Partial remission, duration of response (10 months).
Slide 7 - After the last cycle, she developed GII peripheral neuropathy in the form of numbness in both lower limbs and tinnitus in Lt ear. The patient was kept under FU till 6/10/2004,she had progressive disease.
Slide 8 - A M M + Pretreatment After 4 cycles +
Slide 9 - A M M Pretreatment After 4 cycles
Slide 10 - Pretreatment AMM
Slide 11 - After 4 cycles AMM
Slide 12 - Case 3 MAA 55 ys old male, non smoker, from Alexandria. In 3/2003 CT chest revealed: right pleural thickening and effusion with Rt lower lobe mass. Minor thoracotomy & Pleural biopsy: malignant mesothelioma epithelial type.
Slide 13 - Received Vepesid plus Cisplatin for 6 cycles with progressive disease. Received Navelbine plus Adriamycine for 3 cycles with progressive disease. Presented to the Institute 8/2003 with dyspnea, cough and chest pain so the patient received Pemetrexed plus Cisplatin for 6 cycles started in 1/9/2003 every 21 days.
Slide 14 - CT evaluation after 4 cycles revealed marvelous therapeutic response .The patient was kept under FU for 7 months, he had progressive disease on 3/8/2004 Duration of response 11 months. The patient developed skin rash after 2nd cycle improved with antihistaminic and decadrone, transient elevated liver enzymes and diarrhea grade I.
Slide 15 - + Pretreatment M A
Slide 16 - M A After 4 cycles
Slide 17 - Case 4 MNA, 67y old diabetic male patient , non smoker, living in Helmiat EL zaitoon , Cairo . At presentation in 1/3/2004, he had shortness of breath ,progressive exertional dyspnea of 3 months duration, associated with left chest pain and cough.
Slide 18 - CT examination of the Chest : Left pleural effusion and thickening, sub segmental atelectasis and partial relaxation collapse of left lower lobe. Small left upper pulmonary nodules. Pleural Biopsy : Biphasic malignant pleural mesothelioma
Slide 19 - 8/3/2004 the patient received the first cycle of chemotherapy after premedication with Folic Acid , and Vitamin B12 . Chemotherapy Pemetrexed plus Cisplatin, for 2 courses . After 2 cycles , CT chest 12/4/2004 ----- Partial Regression of pleural thickening , effusion and lung nodules ( PR ) . Patient continued therapy for 8 courses , ended 18/8/2004 , with marked regression of the pleural mass.
Slide 20 - After 7th cycle the patient developed G2 sensory neuropathy of both hands and feet , which regressed with supportive therapy within 2 weeks . After 8th cycle, 18/8/2004 , the patient was kept under follow up with CT of the chest every 3 months. Maintained PR for 12 months, till 8/2005 the patient had progressive disease , Bone Scan showed increased uptake over upper dorsal vertebrae .
Slide 21 - M N + Pretreatment +
Slide 22 - M N After 2 cycles
Slide 23 - After 1 year M N
 

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