Interlobular septal thickening and micronodules with perilymphatic distribution are characteristic CT findings of pleural TB but not empyema. Presence of subpleural abscess and loss of pleural integrity or peripheral bronchopleural fistula are highly suggestive of empyema.

Introduction: Small-cell lung cancer (SCLC) accounts for about 20% of all lung cancers and it has poor prognosis. For extensive disease (ED), combination chemotherapy (CT) with platinum and etoposide is standard, with response rate of 60-80%, but the overall long-term survival is less than 10% (at 5 years) with a median progression-free survival of 4 months. Topotecan produces a response rate of about 24% in sensitive relapse patients (pts). Material and Methods:The authors reviewed 146 consecutive pts with SCLC, diagnosed from January of 2002 to December of 2006, at Portuguese Institute of Oncology -Porto Center, and they evaluated those treated with topotecan as second-line CT, regarding topotecan's efficacy and toxicity. Results: From 146 pts reviewed, 23 were treated with topotecan as second-line CT. 91% were male, the median age was 59 years (range: 23-73) and all of them were smokers or ex-smokers. At time of diagnosis, 78% had ED treated with platinum and etoposide; 22% had limited disease treated with platinum and etoposide plus thoracic radiotherapy. The median time from first line treatment to progression was 7.6 months. At beginning of second-line treatment with topotecan, 74% had a performance status (PS) less than 2 and 26% had a PS of 2. It was used the standard regimen i.v. topotecan at a dose of 1,5 mg/m 2 on days 1-5 of a 21 day cycle. The mean of number of cycles of topotecan done was 3.4 with a range of 1 to 6. Topotecan's disease control was 31.8% (partial response -4 pts, stable disease -3 pts) and median time to progression was 2.6 months. Topotecan grade 3 toxicities described were: anemia in 5 pts, trombocitopenia in 4 pts, neutropenia in 3 pts and vomiting in 1 pt. It was described 2 cases of febrile neutropenia. Median overall survival was 18.2 months. Conclusion: Topotecan has clinical activity in pts with relapsed SCLC, with acceptable toxicity. In this serie of our current daily practice pts, disease control, median time to progression and median overall survival were comparable to other published results. P1-218SCLC: Cytotoxic Chemotherapy Posters, Mon, Sept 3 Evaluation of the Recommended Dose and Efficacy of Amrubicin as 2nd and 3rd-line Chemotherapy for Small-Cell Lung CancerIgawa, Satoshi; Yamamoto, Nobuyuki; Ono, Akira; Nnakamura, Yukiko; Tsuya, Asuka; Murakami, Haruyasu; Endo, Masahiro; Takahashi, Toshiaki Shizuoka Cancer Center, Sunto-gun, Japan Background: After successful induction therapy for small-cell lung cancer (SCLC), most patients relapse within 2 years as a result of emergence of drug-resistant tumor cells. This study was conducted to evaluate the recommended dose and activity of amrubicin (AMR) as 2nd-or 3rd-line chemotherapy for SCLC. Methods: SCLC patients with measurable disease who had previously been treated with at least one platinum-based chemotherapy regimen and had an ECOG performance status of 0-2 were eligible. Two groups of patients were selected: i) a group to be treated with 2nd-line chemotherapy and ii) a group to be treated with 3rd-line chemotherap...

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