A Case of Lung Cancer with Chest Wall Invasion Showed a Pathologically Complete Response to Preoperative Thermo-chemo-radiotherapy

Abstract

A case of lung cancer with chest wall invasion treated by preoperative thermo-chemo-radiotherapy revealed a histologically complete response after complete resection is reported.
A 55-year-old male was diagnosed as primary lung cancer originating from the right upper lobe, cT3N0M0, stage IIB. The tumor invaded the right chest wall accompanied with obstructive pneumonia at its dorsal side and was rapidly growing. Thus, preoperative thermo-chemo-radiotherapy was performed. He was treated with conventional irradiation with a 10 MV X-ray, a total dose of 40 Gy, and concurrent chemotherapy with cisplatin (CDDP) and vinorelbine (VNR). Hyperthermia was applied within 30 min after each radiotherapy with a RF-capacitive heating apparatus (Thermotron RF-8, Ymamamoto Vinyter, Osaka, Japan), 40 min/time, once a week, for a total of 4 times. The tumor revealed necrotic change on CT images after thermo-chemo-radiotherapy and was completely resected. No viable cancer cells were observed in the histological examination (Ef 3). Even 17 months later, there was no recurrence.