Complete Remission of Brain Metastases in Non-Small Cell Lung Cancer Patients Harboring an EGFR Mutation Treated with Tyrosine Kinase Inhibitor without Radiotherapy: A Report of 3 Cases
A 72-year-old woman without a history of smoking presented with supraclavicular lymphadenopathy. An incisional biopsy of the lymph node was performed, and the pathologic result was adenocarcinoma with cytokeratin-7 (CK-7) and thyroid transcription factor-1 (TTF-1) positivity on immunohistochemical staining. The tumor was harboring an EGFR mutation (exon 19 deletion). Whole body PET-CT showed multiple bone metastases with mediastinal lymphadenopathy. Brain MRI identified well-defined enhancing round nodules on the right frontal and left parietal lobes. She received gefitinib (250 mg/day) and palliative radiotherapy for the painful pelvic bone metastases. WBRT was put off because she did not complain of neurologic symptoms. A brain MRI performed 6 months later showed interval regression of multiple BM. The metastatic nodules disappeared after another 3 months (fig. ).