A recurrence-free survivor with chemotherapy-refractory small cell lung cancer after pneumonectomy: A case report and review of the literature

Abstract

Rationale: The optimal therapeutic regimen for chemotherapy-refractory and node-positive small-cell lung cancer (SCLC) is criticizable for the lack of evidence.

Patient concerns: A patient with locally advanced SCLC was insensitive to the first-line chemotherapy of etoposide, irinotecan, and cisplatin.

Diagnoses: The patient was diagnosed as SCLC with mediastinal lymph node metastasis by pathological staining.

Interventions: Salvage pneumonectomy and systematic lymph node dissection combined with oral apatinib and mediastinal radiotherapy were performed for him.

Outcomes: The patient survived for more than 2 years without recurrence after the operation and adjuvant therapy.

Lessons: For patients with chemotherapy-resistant but resectable SCLC, a timely resection combined with postoperative radiotherapy and apatinib might be effective.

Figure 1

(A) CT scan on June 5, 2015 showed progressed central-type lung cancer after the first cycle chemotherapy using etoposide. (B) The tumor enlarged after the second cycle of etoposide. (C) The tumor progressed after the third cycle of chemotherapy using irinotecan. (D) Pathological staining of a tumor section indicated SCLC, by H-E staining (×200), on August 7, 2015. CT = computed tomography, SCLC = small-cell lung cancer.

Figure 2

The schematic illustration of therapeutic regimen of the patient. EP = etoposide and cisplatin, GP = gemcitabine and cisplatin, IP = irinotecan and cisplatin, RT = radiotherapy.