Stereotactic body radiation radiotherapy for oligometastatic non-small cell lung cancer (NSCLC): A case report

• Published in: Cancer radiothérapie Vol. 19; no. 3; pp. 192 - 197
• Main Authors: Leduc, C, Antoni, D, Quoix, É, Noël, G
• Format: Journal Article
• Language: French
• Published: France 01.05.2015
• Subjects: Adenocarcinoma - diagnostic imaging; Adenocarcinoma - radiotherapy; Adenocarcinoma - secondary; Adrenal Gland Neoplasms - radiotherapy; Adrenal Gland Neoplasms - secondary; Aged, 80 and over; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - radiotherapy; Brain Neoplasms - secondary; Carcinoma in Situ - surgery; Carcinoma, Non-Small-Cell Lung - diagnostic imaging; Carcinoma, Non-Small-Cell Lung - radiotherapy; Carcinoma, Non-Small-Cell Lung - secondary; Humans; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - radiotherapy; Lung Neoplasms - surgery; Male; Pericardial Effusion - etiology; Radiosurgery - methods; Remission Induction; Tomography, X-Ray Computed; Stereotactic body radiation therapy; NSCLC; Traitement curatif; Cancer bronchique non à petites cellules; Non-small cell lung cancer; SBRT; Ablative therapy; Oligométastatique; Radiothérapie en conditions stéréotaxiques; CBNPC; Oligometastatic disease
• ISSN: 1769-6658
• DOI: 10.1016/j.canrad.2014.12.007

Metastatic non-small cell lung cancer is associated with a poor prognosis, and palliative chemotherapy is the mainstay of treatment. However, long-time survival has been observed in oligometastatic patients treated with locally ablative therapies to all sites of metastatic disease. An 80-year-old man was diagnosed with an adenocarcinoma of the lung. The right upper lobe lesion was classified cT2aN0M0 and was treated with stereotactic body radiation therapy at the dose of 60Gy in eight fractions. A few months after, he successively presented with two brain metastases and one left adrenal metastasis, with a complete response on the primary tumor. The three secondary lesions were treated with stereotactic body radiation therapy alone. Thirty months after the diagnosis and 12months after metastases' apparition, primary and brain lesion kept controlled (complete response). Oligometastatic non-small cell lung cancer management is not clear. Locally ablative therapies such as stereotactic body radiation therapy, surgery and radiofrequency are efficient and should be considered. A phase III study should evaluate radical treatment strategies in such patients.