Case Presentation :
Case Presentation AC 55, Smoker 15/day until 24yrs from age 17
April 2005
Abnormal CXR, unresolving chest infection
Ix – stage IIIB NSCLC
Moderately differentiated squamous cell carcinoma, TTF1 +ve
PS 1, breathless
Slide 3:
. TTF1 positive,
flattened polyhedral cells,
Intracellular and extracellular keratinization
Intercellular bridges
Questions? :
Questions?
Treatment :
Treatment Phase III clinical trial, BTOG 2
Cisplatin 80mg/m2 & Gemcitabine1250mg/m2 d 1+8 4 cycles
CT after 2 cycles = PR
Had radical radiotherapy consolidation 55Gy in 20 fractions
Recurrence April 2006 ( 4 months after initial chemotherapy) :
Recurrence April 2006 ( 4 months after initial chemotherapy) PS 2
Dyspnoea and pain, (posterior right rib erosion, collapse RUL and effusion).
Given 20Gy in 5 fractions May 2006.
Options……?
Options….. :
Options….. Retreat with cisplatin doublet……
Docetaxel
Pemetrexed
Erlotinib
Clinical trial