title: Toxic risk of stereotactic body radiotherapy and concurrent helical tomotherapy followed by erlotinib for non-small-cell lung cancer treatment--case report.
abstract: BACKGROUND
  Stereotactic body radiation therapy (SBRT) applied by helical tomotherapy (HT) is feasible for lung cancer in clinical. Using SBRT concurrently with erlotinib for non-small cell lung cancer (NSCLC) is not reported previously.
  
  
  METHODS
  A 77-year-old man with stage III NSCLC, received erlotinib 150 mg/day, combined with image-guided SBRT via HT. A total tumor dose of 54 Gy/9 fractions was delivered to the tumor bed. The tumor responded dramatically and the combined regimen was well tolerated. After concurrent erlotinib-SBRT, erlotinib was continued as maintenance therapy. The patient developed dyspnea three months after the combined therapy and radiation pneumonitis with interstitial lung disease was suspected.
  
  
  CONCLUSIONS
  Combination SBRT, HT, and erlotinib therapy provided effective anti-tumor results. Nonetheless, the potential risks of enhanced adverse effects between radiation and erlotinib should be monitored closely, especially when SBRT is part of the regimen.
authors.affiliation: Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan. chenci28@ms49.hinet.net
authors.forename: Chen-Hsi
authors.initials: CH
authors.lastname: Hsieh
authors.forename: Hou-Tai
authors.initials: HT
authors.lastname: Chang
authors.forename: Shih-Chiang
authors.initials: SC
authors.lastname: Lin
authors.forename: Yu-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Wang
authors.forename: Yen-Ping
authors.initials: YP
authors.lastname: Hsieh
authors.forename: Chien-An
authors.initials: CA
authors.lastname: Chen
authors.forename: Ngot-Swan
authors.initials: NS
authors.lastname: Chong
authors.forename: Shoei Long
authors.initials: SL
authors.lastname: Lin
authors.forename: Chun-Yi
authors.initials: CY
authors.lastname: Chen
authors.forename: Pei-Wei
authors.initials: PW
authors.lastname: Shueng
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000201:enzymology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D019583:Dose Fractionation, Radiation; D004417:Dyspnea / Q000209:etiology; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D000069347:Erlotinib Hydrochloride; D017809:Fatal Outcome; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000209:etiology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000201:enzymology / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D011799:Quinazolines / Q000009:adverse effects*; D017564:Radiation Pneumonitis / Q000209:etiology; D016634:Radiosurgery / Q000009:adverse effects*; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; C512478:EGFR protein, human; D066246:ErbB Receptors