Author of

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  P2.24 - Poster Session 2 - Supportive Care (ID 157)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11973

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    P2.24-027 - Cisplatin plus pemetrexed and concurrent radiation with consecutive surgery in locally advanced adenocarcinoma of the right lung - case report (ID 1642)

    09:30 - 09:30  |  Author(s): T. Buchler
    • Abstract

    Background
    Locally advanced non-small cell lung cancer has poor prognosis with less than 20% probability of 5-year survival despite the use of concurrent chemoradiotherapy. Last generation chemotherapy regimen, high dose of radiotherapy, and surgery if feasible are options to achieve better outcomes in highly selected cases.

    Methods
    A case report of a 25-year woman with non-mutated adenocarcinoma of the right lung is presented in this work.

    Results
    The young woman, age 25 years, smoker of 1 pack/day since the age of 18 years, without family cancer history presented with right lung perihilar mass. CT scan showed tumor infiltration of the right upper lobe of 73x65x80 mm involving mediastinum as well as enlargement of right hilar and mediastinal lymph nodes. Suspicion of left aortic arc lymph nodes infiltration was described on FDG-PET/CT but no distant metastases were seen. Transbronchial biopsy confirmed adenocarcinoma. EGFR mutation and ALK translocation were not found. TNM stage (UICC7) was T4N2-3M0 – clinical stage IIIB. Performance status 1, cough, dyspnoea and mild weight loss at time of diagnosis were noted. Treatment consisted of 5 cycles of chemotherapy with cisplatin and pemetrexed in standard doses every 3 weeks and concurrent radiotherapy given in the dose of 72Gy/36 fraction/7.5 weeks during 3-5th cycle. Restaging after CRT showed substantial partial remission with negative mediastinal lymph nodes on PET/CT scan, therefore surgery was proposed, resulting in right upper lobectomy and mediastinal lymphadenectomy. The histology showed residual adenocarcinoma 35x20x45mm with regressive signs, stage ypT2 ypN0. Whole-body and brain FDG-PET/CT two months after surgery confirmed complete remission. No additional chemotherapy nor prophylactic cranial irradiation were indicated but close follow-up has been planned because of the high risk of recurrent distant metastases.

    Conclusion
    This case report showed successful multimodal therapy of advanced NSCLC in a very young woman whose age and good PS warranted aggressive treatment approach. This abstract was supported by a grant from the Ministry of Health of the Czech Republic – IGA MZ CR NT12331-5/2011 and by a grant from the Charles University Prague PRVOUK - P27.