Let me share with you today about a case I had couple of months back. Mdm. T is a 55 years old female who has no comorbid. She was found to have stage 4 lung cancer after the disease had spread to her brain and bones. Before starting therapy, she had a brain MRI, which revealed a large lesion in the left cerebellum as well as over 80 other small lesions in the brain. Her lung biopsy revealed an adenocarcinoma that had not undergone any mutations (EGFR, ALK, ROS1, etc. were all negative). She had no other options other than chemotherapy, which was unfortunate. If she has a mutation, she could begin with oral targeted therapy. As the medications penetrate the blood brain barrier, it will effectively control cancers in the brain. Because chemotherapy typically cannot cross the blood brain barrier, she required radiotherapy to the brain in order to achieve effective tumor control.
Pre Gamma Knife on diagnosis
Initially I planned for a tumor debulking for the largest tumor in the left cerebellum as she had neurological symptoms but she refused surgery. I offered her Gamma Knife as usual as its non-invasive and simple to do as an outpatient. I had to divide her therapy over 5 days because she had more than 80 lesions, treating various areas of the brain on different days.
I was actually surprised to see a complete response in her MRI brain 3 months after Gamma Knife Radiosurgery. She is well now with no neurological symptoms and is completing her chemotherapy soon.
Post Gamma Knife 3 months later
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