Medical management of pulmonary carcinoid tumors.

Abstract

e18512 Background: The optimal medical management of pulmonary carcinoid tumors, which comprise 1-2% of all lung cancers, remains to be determined. Methods: We conducted a retrospective review of patients with typical and atypical pulmonary carcinoid tumors treated at our institution between 1990-present. Results: We identified 29 patients treated with chemotherapy, including 21 patients with metastatic disease (19 atypical, 2 typical), and 8 patients treated with adjuvant platinum-etoposide chemoradiation (6 atypical, 2 typical, 6 stage IIIA, 2 stage IIB). At an average follow-up of 12 months there were two recurrences in the 8 patients receiving adjuvant treatment, both of whom had atypical carcinoid (1 stage IIIA, 1 stage IIB). Of patients with metastatic disease, the principal sites of metastasis were the liver (70%), bone (40%), and brain (25%); median survival after diagnosis of metastatic disease was 3.8 y with a 5 y survival of 37%. Regimens showing efficacy in metastatic disease include octreotide (92% stable disease), etoposide-cisplatin (25% disease control, 2 partial response, 1 stable disease), and temozolomide (44% disease control, 2 partial responses, 2 stable disease). Conclusions: These results support our previous finding that pulmonary carcinoid tumors are responsive to chemotherapy and that adjuvant therapy should be offered to patients with stage II or IIIA resected disease.