[Long-term survival with complete response by gefitinib treatment followed by noncurative operation for lung cancer]

A 54-year-old man was referred to our hospital because of an abnormal shadow on chest X-ray. A computed tomography( CT) scan of the chest revealed a 6.5 cm tumor in the right upper lobe suspected of superior vena cava (SVC) infiltration. He was diagnosed as lung cancer(adenocarcinoma), and the right upper lobectomy with partial resection of SVC was performed. But the pathology confirmed the surgery to be non-curative. Nine months after operation, carcinomatous pleuritis was detected on chest X-ray. Since deoxyribonucleic acid (DNA)analysis revealed a mutation of epidermal growth factor receptor (EGFR) gene in exon 21, gefitinib treatment was started. Nine months later, pleural effusion regressed and his cerum carcinoembrionic antigen( CEA) level was normalized. 4 years later, gefitinib was discontinued by patient's request, however, he is alive without any signs of relapse 9 years after the operation.