Patient diagnosis and history:
A 47-year-old male previously treated for adenocarcinoma of the right upper lung presented with a metastasis in the lingua segment of the left upper lobe in March 2006. The metastasis was diagnosed using a contrast enhanced CT scan. The patient was evaluated and elected to proceed with a course of image guided hypofractionated stereotactic radiation therapy.
The patient was first diagnosed as having a low-differentiated adenocarcinoma of the right upper lobe of the lung (stage IIIA) in March 2004 with the primary tumor in the upper apical-posterior segment of the right lung, right hilum, and an upper mediastinal lymph node metastasis. The patient was treated with right upper lung lobectomy and mediastinal lymph node dissection followed by adjuvant alternate chemotherapy (vinorelbine 40mg iv drip, days one and eight, cisplatin 50mg, IV drip, days one to three – 21 days per cycle for a total of four cycles) and radiation therapy.
Feng Xu MD, Hong Zhang MD., Jin Wang MD., Yali Shen MD.
Sen Bai MS., Xiaoqin Jiang, Renming Zhong, Qingfeng Xu, Xiaoyu Li, Qingfeng Jiang