Chemoradiotherapy followed by continued immunotherapy for out-of-field progression during consolidation in limited-stage SCLC: a case report

TL;DR

A patient with lung cancer developed a new tumor during treatment, but combining targeted radiation and ongoing immunotherapy led to a full recovery.

Contribution

A novel treatment approach combining salvage radiotherapy and continued immunotherapy for isolated nodal recurrence during consolidation in SCLC.

Findings

The patient achieved complete response of both the primary tumor and metastatic lymph node.

The treatment approach resulted in minimal toxicity.

The case suggests potential for combining salvage radiotherapy with continued immunotherapy.

Abstract

While consolidation immunotherapy after chemoradiotherapy (CRT) improves survival in limited-stage small cell lung cancer (LS-SCLC), some patients develop out-of-field progression during consolidation. Optimal management in such cases remains undefined.

We describe a 49-year-old male with LS-SCLC who developed supraclavicular lymph node metastasis during consolidation immunotherapy following definitive CRT. The patient underwent concurrent chemoradiotherapy targeting the recurrent node, followed by continued consolidative immunotherapy. This approach led to complete response of both the primary tumor and the metastatic lymph node, with minimal toxicity.

This case highlights the potential role of combining salvage radiotherapy with continued immunotherapy in managing isolated nodal recurrence during consolidation. Further studies are warranted to validate this individualized strategy.

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