Long-Term Survival after Induction Therapy Followed by Concurrent Target-Radiotherapy of an Unresectable Stage IIIB Non-Small Cell Lung Cancer Patient: Case Report

Abstract

Concurrent chemoradiotherapy (CCRT) is the standard therapy for patients with unresectable locally advanced non-small cell lung cancer (NSCLC). CCRT is usually associated with various levels of complications due to the dosage of either chemotherapy regimen or radiation; therefore, only patients with good performance status were qualified for this aggressive treatment. Gefitinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), is well tolerated compared with most chemotherapy regimens in treating NSCLC patients, and there is no need to decrease the dosage of gefitinib when combined with radiotherapy. Induction chemotherapy, although not recommended in the treatment strategy for patients with unresectable NSCLC, may be appropriate for select patients who are most likely to benefit from subsequent CCRT. In this case, we report on an unresectable stage IIIB NSCLC patient, who had failed to two lines of chemotherapy, received gefitinib followed by concurrent target-radiotherapy with complete remission and long-term disease free survival for 2 years. We suggest that patients with unresectable NSCLC should be initially considered to receive induction chemotherapy or target therapy and plan further treatment such as radiotherapy or surgery according to the response.