Oligorecurrent Non-Small-Cell Lung Cancer Treated by Chemo-Radiation Followed by Immunotherapy and Intracranial Radiosurgery: A Case Report and Mini Review of Literature.
Alessio BruniFederica BertoliniElisa D'AngeloGiorgia GuaitoliJessica ImbresciaAnna CappelliGabriele GuidiAlessandro StefaniMassimo DominiciFrank LohrPublished in: International journal of molecular sciences (2023)
Locally advanced non-small-cell lung cancer still represents a "grey zone" in terms of the best treatment choice and optimal clinical outcomes. Indeed, most patients may be suitable to receive different treatments with similar outcomes such as chemo-radiotherapy (CHT-RT) followed by immunotherapy (IO) or surgery followed by adjuvant local/systemic therapies. We report a clinical case of a patient submitted to primary thoracic surgery who developed a mediastinal nodal recurrence successfully treated by CHT-RT-IO. Subsequently, a single brain lesion was found to have been successfully treated by single fraction stereotactic ablative radiotherapy. The patient is still on follow-up and she is free from disease having a good quality of life. In this report, we also perform a mini review about the role of CHT-RT followed by IO in treating loco-regional relapse after surgery. The role of SABR after IO is also evaluated, finding that it is safe and well tolerated. More robust and larger clinical data are needed in this particular setting to better define the role of the combination of systemic and local treatments in the management of intrathoracic and intracranial relapse for patients already submitted to CHT-RT followed by immunotherapy.
Keyphrases
- end stage renal disease
- advanced non small cell lung cancer
- newly diagnosed
- early stage
- ejection fraction
- chronic kidney disease
- locally advanced
- prognostic factors
- photodynamic therapy
- peritoneal dialysis
- lymph node
- radiation therapy
- type diabetes
- minimally invasive
- case report
- squamous cell carcinoma
- small cell lung cancer
- thoracic surgery
- free survival
- brain injury
- brain metastases
- acute coronary syndrome
- neoadjuvant chemotherapy
- cancer therapy
- patient reported
- skeletal muscle
- electronic health record
- cerebral ischemia
- subarachnoid hemorrhage
- decision making
- drug induced