CT detected indeterminate pulmonary nodules in a chemoprevention trial of fluticasone.
BACKGROUND
In animal models of lung carcinogenesis, inhaled corticosteroids appear to reduce the number of new lung tumors. In a trial of budesonide in smokers with bronchial dysplasia, the proportion of indeterminate CT detected pulmonary nodules that resolved was larger in the treatment group. We performed a secondary analysis of CT data of subjects at risk of lung cancer enrolled in a chemoprevention trial of fluticasone.


METHODS
Subjects with bronchial squamous metaplasia or dysplasia had a baseline chest CT scan. They were randomized to fluticasone or a placebo. After 6 months a repeat CT was performed and the change in number and size of nodules was evaluated.


RESULTS
Two hundred and one subjects were screened. Of the 108 volunteers included in the study, 74 were male, mean age was 53 years and mean number of pack years 48. Baseline: 35 subjects had 91 nodules in total, 62% <4mm. In the fluticasone arm more subjects had a decrease and fewer had an increase in number of nodules, however this trend did not reach statistical significance.


CONCLUSIONS
In this preliminary study there was a tendency of nodules to resolve, however, studies with CT detected nodules as inclusion criterion are needed.
van den Berg
Remco M
RM
Department of Pulmonology, VU University Medical Center, Boelelaan 1117, 1081HV Amsterdam, The Netherlands.
Teertstra
H Jelle
HJ
Department of Radiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands.
van Zandwijk
Nico
N
Department of Thoracic Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands.
van Tinteren
Harm
H
Department of Biometrics, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands.
Visser
Christien
C
Department of Thoracic Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands.
Pasic
Arifa
A
Department of Pulmonology, VU University Medical Center, Boelelaan 1117, 1081HV Amsterdam, The Netherlands.
Sutedja
Thomas G
TG
Department of Pulmonology, VU University Medical Center, Boelelaan 1117, 1081HV Amsterdam, The Netherlands.
Baas
Paul
P
Department of Thoracic Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX Amsterdam, The Netherlands.
Golding
Richard P
RP
Department of Radiology, VU University Medical Center, Boelelaan 1117, 1081HV Amsterdam, The Netherlands.
Postmus
Pieter E
PE
Department of Pulmonology, VU University Medical Center, Boelelaan 1117, 1081HV Amsterdam, The Netherlands.
Smit
Egbert F
EF
Department of Pulmonology, VU University Medical Center, Boelelaan 1117, 1081HV Amsterdam, The Netherlands. Electronic address: ef.smit@vumc.nl.
D000328:Adult; D000368:Aged; D000730:Androstadienes / Q000627:therapeutic use*; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008175:Lung Neoplasms / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*
D000730:Androstadienes; D000068298:Fluticasone