Toxic risk of stereotactic body radiotherapy and concurrent helical tomotherapy followed by erlotinib for non-small-cell lung cancer treatment--case report

BMC Cancer. 2010 Dec 31:10:696. doi: 10.1186/1471-2407-10-696.

Abstract

Background: 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.

Case presentation: 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.

Conclusions: 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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents / adverse effects*
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / enzymology
  • Carcinoma, Non-Small-Cell Lung / therapy*
  • Chemotherapy, Adjuvant
  • Dose Fractionation, Radiation
  • Dyspnea / etiology
  • ErbB Receptors / antagonists & inhibitors
  • Erlotinib Hydrochloride
  • Fatal Outcome
  • Humans
  • Lung Diseases, Interstitial / etiology
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / enzymology
  • Lung Neoplasms / therapy*
  • Male
  • Neoplasm Staging
  • Protein Kinase Inhibitors / adverse effects*
  • Quinazolines / adverse effects*
  • Radiation Pneumonitis / etiology
  • Radiosurgery / adverse effects*
  • Radiotherapy, Adjuvant
  • Radiotherapy, Conformal / adverse effects*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Quinazolines
  • Erlotinib Hydrochloride
  • EGFR protein, human
  • ErbB Receptors