[A case of long-term survival of postoperative brain metastasis of small cell lung cancer effectively treated with chemotherapy, whole brain radiotherapy and stereotactic radiosurgery].
A 63-year-old woman underwent right upper lobectomy for small cell carcinoma. She received a total of 2 courses of carboplatin and etoposide infusion as adjuvant therapy. One year after the operation, because of elevated serum Pro GRP levels and a metastatic brain tumor revealed by CT, 4 courses of IP therapy (irinotecan 60 mg/m(2), day 1, 8, 15 and cisplatin 60 mg/m(2), day 1, every 4 weeks) and whole brain radiotherapy (2 Gy f, 5 f/week, total 40 Gy) were given. A complete response was obtained, but a tumor relapse occurred ten months after the last chemotherapy. We then performed a stereotactic radiosurgery (marginal dose: 22 Gy, maximum dose 44 Gy), and one month later MRI showed the tumor had shrunk markedly. FDG-PET showed no intensive uptake, suggesting that there was no remaining viable tumor. No severe side effects were observed during these treatments. Currently, the patient has been alive with good performance status and no signs of relapse.
Yohena
Tomofumi
T
Dept. of General Thoracic Surgery, National Okinawa Hospital.
Kuniyoshi
Masayuki
M
Teruya
Takao
T
Kawasaki
Hidenori
H
Teruya
Jun
J
Kawabata
Tsutomu
T
Ohta
Morio
M
Ishikawa
Kiyoshi
K
Oshiro
Yasuji
Y
Chinen
Tetsuji
T
Uehara
Tadahiro
T
Hirayasu
Tsuneo
T
Ogawa
Kazuhiko
K
Samura
Hirofumi
H
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D002945:Cisplatin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016634:Radiosurgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D005047:Etoposide; D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin