Author of

• 11946

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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

  • 12003

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    P2.24-057 - Stereotactic Body Radiation Therapy (SBRT) - The success of a new technique in a complex clinical case (ID 3384)

    09:30 - 09:30  |  Author(s): M. Mendes
    • Abstract

    Background
    SBRT is an emerging technique, with numerous advantages over classical radiotherapy, namely in high surgical risk patients.

    Methods
    Critical review of a clinical case

    Results
    The authors report the case of a 37 year-old man, type 1 Neurofibromatosis patient, with dorsal paraplegia secondary to paravertebral tumours, severe kiphoscoliosis, and chronic hypercapnic respiratory failure requiring continuous non-invasive ventilation (NIV) since 2007. He was also medicated with Baclofen 125mg/day and botulinum toxin for severe spasticity, with poor response. In May 2010, he was diagnosed with testicular malignancy, which has undergone radical resection under local anaesthesia. In June 2010 he was submitted to a follow-up CT scan, which revealed a 9mm pulmonary nodule on the right upper lobe that remained under supervision, due to the risks of invasive diagnostic procedures. In January 2012, because of a significant size increase, a CT scan-guided biopsy of the lesion was performed, which revealed a lymphoepithelioma-like carcinoma. Subsequent CT-scans demonstrated progressive growth of the neoformation (4.9cm in July 2012) with invasion of the thoracic wall, and the PET/CT scan revealed FDG-F18 hyper fixation. Due to the comorbidities, and the need for continuous NIV, he had no surgical, chemotherapy or classical radiotherapy conditions. The remaining treatment option was SBRT. Therefore, a planning 4D-CT scan with a vacuum mattress for immobilization was performed, and a therapy plan was defined to deliver a total dose of 48Gy, in four fractions of 12Gy, in alternate days, with support of Image-Guided Radiation Therapy (IGRT) technology. There was a good clinical and haematological tolerance, no acute or late complications were referred, and the 6 months follow-up CT-scans showed partial response, according to RECIST criteria.

    Conclusion
    SBRT is nowadays a valid alternative for lung cancer treatment in patients with medical contraindications to surgical treatment, demonstrating a high local control of the lesion, associated with low toxicity effects. Figure 1Figure 2