Toxic risk of stereotactic body radiotherapy and concurrent helical tomotherapy followed by erlotinib for non-small-cell lung cancer treatment - case report
1 Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan
2 Department of Chest Medicine, Division of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
3 Department of hematology, Far Eastern Memorial Hospital, Taipei, Taiwan
4 Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan
5 Institutes of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
6 Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan
7 School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
8 Department of Healthcare Administration, Asia University, Taichung, Taiwan
9 Department of Surgery, Taipei Hospital, Department of Health, Taipei, Taiwan
10 Division of Medical Oncology, Department of Internal Medicine, Taipei Hospital, Department of Health, Taipei, Taiwan
BMC Cancer 2010, 10:696 doi:10.1186/1471-2407-10-696Published: 31 December 2010
Stereotactic body radiation therapy (SBRT) applied by helical tomotherapy (HT) is feasible for lung cancer in clinical. Using SBRT concurrently with erlotinib for non-small cell lung cancer (NSCLC) is not reported previously.
A 77-year-old man with stage III NSCLC, received erlotinib 150 mg/day, combined with image-guided SBRT via HT. A total tumor dose of 54 Gy/9 fractions was delivered to the tumor bed. The tumor responded dramatically and the combined regimen was well tolerated. After concurrent erlotinib-SBRT, erlotinib was continued as maintenance therapy. The patient developed dyspnea three months after the combined therapy and radiation pneumonitis with interstitial lung disease was suspected.
Combination SBRT, HT, and erlotinib therapy provided effective anti-tumor results. Nonetheless, the potential risks of enhanced adverse effects between radiation and erlotinib should be monitored closely, especially when SBRT is part of the regimen.