A Case of Salvage Surgery for Lung Cancer After 40 Courses of Pemetrexed Maintenance Therapy for 3 Years Following the Treatment of Brain Metastases

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  • Iwatsubo Shigeaki
    Department of Pulmonary Medicine, Respiratory Disease Center, Kyoto Katsura Hospital
  • Hashimoto Michinobu
    Department of Pulmonary Medicine, Respiratory Disease Center, Kyoto Katsura Hospital
  • Nishimura Tomoko
    Department of Pulmonary Medicine, Respiratory Disease Center, Kyoto Katsura Hospital
  • Nishimura Takashi
    Department of Pulmonary Medicine, Respiratory Disease Center, Kyoto Katsura Hospital
  • Terada Yasuji
    Department of Thoracic Surgery, Respiratory Disease Center, Kyoto Katsura Hospital
  • Yasuhara Yumiko
    Department of Pathology, Kyoto Katsura Hospital

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Other Title
  • 脳転移の治療後，3年間にペメトレキセド維持療法を40コース施行した肺癌症例に，サルベージ手術を施行した1例

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<p>Background. We report a case of salvage surgery for lung cancer with the treatment of brain metastases and 3 years of maintenance chemotherapy. Case. A 55-year-old woman consulted a hospital complaining of headache, dizziness and speech disorder. She was diagnosed with two brain tumors and underwent surgical resection for one of them. The pathological examination of the excised brain tumor revealed adenocarcinoma, and chest computed tomography (CT) also revealed a lung tumor invading the mediastinal pleura in the left upper lobe. She was diagnosed with lung cancer (cT3N0M1b, stage IV). Gamma knife radiosurgery was performed for the other metastatic brain tumor. After undergoing treatment for her brain metastases, she was introduced our hospital for lung cancer treatment. She received 4 cycles of combination chemotherapy with cisplatin (CDDP) and pemetrexed (PEM) followed by 3 years (40 cycles) of maintenance chemotherapy with PEM. The lung tumor remarkably diminished, and no regrowth or new metastasis was observed during the period of maintenance chemotherapy. We therefore performed left upper lobe lobectomy as salvage surgery. The pathological examination of the excised lung tumor revealed no viable cells. The patient's postoperative course was uneventful and no recurrence was found at 11 months after surgery. Conclusion. We experienced a case of salvage surgery for lung cancer after long-term maintenance chemotherapy with PEM and the treatment of multiple brain metastases. Salvage surgery should be indicated for patients who undergo long-term maintenance chemotherapy.</p>

Journal

  • Haigan

    Haigan 56 (5), 379-384, 2016

    The Japan Lung Cancer Society

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