Case: A 52-Year-Old Male With Stage IIIA NSCLC
Initial presentation
- A 52-year-old man presented with a 15-lb weight loss and worsening dyspnea
- PMH: HTN
- SH: Computer programmer; Smoked a pack/day for 30 years; Quit smoking 2 years ago; Married with 4 kids
- PE: Unremarkable
Clinical workup
- Imaging:
- Initial CT showed a 5-cm left upper lobe mass with aortopulmonary window and left paratracheal adenopathy measuring up to 2.5 cm
- Subsequent PET scan showed activity in the left upper lobe mass and all nodal areas
- No extrathoracic disease was identified
- MRI showed no brain metastases
- Mediastinal sampling: EBUS was performed and documented squamous carcinoma in the left paratracheal lymph nodes
- Staging: T2N2M0
- ECOG PS 1
- Multidisciplinary tumor board deemed his tumor unresectable due to multistation N2 disease
Treatment
- Concurrent cisplatin/etoposide with external-beam radiotherapy
- Repeat CT 4 weeks after completion of concurrent chemoradiotherapy showed a PR with no new sites of disease