title: Successful gefitinib treatment administration via gastrostomy tube in a patient with non-small cell lung cancer with dysphagia.
abstract: A 72-year-old woman with dysphagia was diagnosed with lung adenocarcinoma and metastatic meningeal tumour that impaired the medulla. Owing to a bulky tumour beside the medulla, radiosurgical control of the meningeal tumour was achieved before systemic therapy. Genomic examination of the tumour revealed an existing epidermal growth factor receptor (EGFR) exon 19 deletion, for which an EGFR tyrosine kinase inhibitor such as gefitinib was the standard therapy. However, because of dysphagia, the patient was unable to orally ingest gefitinib. Gefitinib was delivered via gastrostomy tube as a suspension after spontaneous dissolution in hot water. One month later, the patient's symptoms, including dysphagia, were drastically improved and she had recovered sufficiently to orally ingest gefitinib. Gefitinib-associated toxicity comprises only mild liver dysfunction and skin rash. CT scanning and MRI detected drastic shrinkage of the primary lung and meningeal tumours. The patient continued to take gefitinib and has remained symptom-free for 9 months.
authors.affiliation: Izumi Municipal Hospital, Izumi-shi, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Suzumura
authors.forename: Kimio
authors.initials: K
authors.lastname: Yonesaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsukuda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fukuoka
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy*; D000077192:Adenocarcinoma of Lung; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000188:drug therapy*; D003680:Deglutition Disorders / Q000209:etiology*; D004333:Drug Administration Routes; D005260:Female; D005774:Gastrostomy; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy*; D011799:Quinazolines / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000077156:Gefitinib