[Lobectomy for local recurrence of lung cancer after 3-dimensional-conformal radiotherapy]

An 85-year-old man was diagnosed as having primary cancer located in the middle lobe (squamous cell carcinoma cT1N0M0 stage IA). Because of his general conditions and status as an octogenarian, 3-dimensional-conformal radiotherapy (3D-CRT, 75Gy in 25 fractions) was selected. The therapeutic response was partial remission, and the adverse reaction was radiation pneumonitis (grade 2). Seventeen months after 3D-CRT, local recurrence was detected. Surgery was performed. Thoracoscopic findings demonstrated scarring fibrosis in the middle lobe and there was no adhesion in the pulmonary hilum. Therefore, video-assisted thoracoscopic lobectomy was performed safely. The patient was discharged on the 10th days post operatively without complication. After 12 months follow-up, there has been no recurrence.