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Vol.57 No.6 contents | Japanese/English |
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- Case Report -
A Case of Small Cell Lung Cancer in Complete Remission for Nine Years After Recurrence by Solitary Brain Metastasis and Treatment with Stereotactic Irradiation
Takuya Kakutani1, Yuichi Ozawa1, Hirotsugu Hasegawa1, Takashi Matsui1, Koushi Yokomura1, Takafumi Suda21Department of Respiratory Medicine, Respiratory Disease Center, Seirei Mikatahara General Hospital, Japan, 2Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
Background. Small cell lung cancer (SCLC) easily metastasizes to the central nervous system, and, even in the limited stage, around 50% of patients develop brain metastasis over the course of the disease. While whole-brain radiotherapy (WBRT) is recommended for the treatment of brain metastasis, several recent studies have shown that WBRT can cause neurotoxicity, including long-term cognitive deterioration. Although stereotactic irradiation (SRI) is reported to be effective on brain metastasis from many types of cancers without clear neurotoxicity, the clinical benefits in patients with brain metastasis from SCLC remain unclear. Case. A 75-year-old male was diagnosed with SCLC at the limited stage (cT2N2M0) and treated with cisplatin/etoposide combined with concurrent irradiation in accelerated hyperfractionation (45 Gy/30 Fr). Although all visible thoracic lesions disappeared after the 4-cycle treatment, brain magnetic resonance imaging (MRI) detected a newly emerged, solitary, 5-mm nodule in the right cerebellum. The metastasis was treated with γ-knife (40 Gy/1 Fr) alone and carefully followed by periodical brain MRI. Three months later, the brain metastasis vanished, resulting in complete remission. Notably, while periodic brain MRI was continued every three months for the first five years and every six months for the subsequent four years without further additional irradiation to the brain, no recurrence was seen, and complete remission status was maintained. Conclusion. The current case indicates that some patients with brain metastasis from SCLC can be managed for a sufficiently long time by SRI alone.
key words: Small cell lung cancer, Stereotactic irradiation, Brain metastasis, Oligo-metastasis
Received: December 19, 2016
Accepted: July 24, 2017
JJLC 57 (6): 775-780, 2017
