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Saroj Kumar Das Majumdar

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    P3.CR - Case Reports (Not CME Accredited Session) (ID 984)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.CR-02 - SBRT of Lung Primary After Complete Resolution of Metastatic Disease in Case of EGFR Mutated Adenocarcinoma Lung: A Case Report (ID 14464)

      12:00 - 13:30  |  Presenting Author(s): Saroj Kumar Das Majumdar

      • Abstract


      Lung cancer accounts for the highest malignancy related mortality among males worldwide. The prognosis of metastatic lung cancer is dismal and as per data from United States of America, the 5-year survival of metastatic lung cancer patients stands at mere 5 percent. Loco-regional management in metastatic lung cancer is not routinely practiced, however exceptions are made in patients who have very good response to systemic treatment. In such cases loco-regional treatment is expected to improve disease free survival.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Section Not applicable

      4c3880bb027f159e801041b1021e88e8 Result

      Fifty-six year old male, known hypothyroid[on thyroxine supplementation] without any significant history of addiction/family history presented with chronic non-productive cough and acute breathlessness. On evaluation left lung upper lobe primary mass [adenocarcinoma on histopathology] and left sided pleural and pericardial effusion[malignant on cytology]as well as multiple cervical lymphadenopathy was found on PET-CT. Hundred percent of the primary tumour tissue was found to harbour EGFR mutation while being negative for ALK mutation. After six cycles of chemotherapy with Carboplatin and Pemetrexed combination chemotherapy regimen, the patient was kept on Erlotinib for 9 months. All the metastatic diseases were found to be resolved and primary was shrunken on assessment PET-CT. Patient was advised for SBRT to primary 50Gy in 5 fractions,10Gy per fraction on alternate days over a period of 10 days following which he has been kept on Tab Erlotinib. The patient has a survival of 18 months calculated from the time of diagnosis till compilation of data and is disease free.

      8eea62084ca7e541d918e823422bd82e Conclusion

      High percentage of EGFR mutation can provide very good response to tyrosine kinase inhibitor therapy in case of metastatic adenocarcinoma lung. Partial response at primary with resolution of metastatic disease throws a challenge for use of loco-regional modality of management in tandem with systemic treatment.