P3-18-6A CASE OF ELDERLY LUNG CANCER WITH MALIGNANT PLEURAL EFFUSION AND PNEUMOTHORAX TREATED BY CBDCA, PEM AND Bev

Abstract We report an elderly non-small -cell non- squamous cell lung cancer patient with chemotherapy by carboplatin (CBDCA), pemetrexed (PEM), bevacizumab (Bev) has been successfully treated. The patient was an 84 -year-old man. He complained of dyspnea. The right lung collapsed completely for pleural effusion and the mediastinum shifted to the left side. He was complicated by pneumothorax after the right thoracic drainage and received a thoracotomy. Absorbent tissue reinforcing agent was attached to the part of air leakage and fibrin glue was applied. Histopathological examination of the specimen of parietal pleura revealed adenocarcinoma. After discharge, he was administrated PEM 500mg/m2 + Bev 15mg/kg for the first course and had no serious side effect. CBDCA AUC4 was added from the second course. After 7 courses administration, pleural effusion almost disappeared and primary tumor of right upper lobe shrank. Administration of PEM + Bev was continued thereafter. Right pleural effusion was well controlled up to 12 months (all 14 courses) from the start of the administration, and the primary tumor of right upper lobe was maintained shrink. Side effects were mild and the chemotherapy was administered safety. After 16 courses administration, left malignant pleural effusion was observed, and he passed away in 15 months after the start of chemotherapy.