[Multidisciplinary Treatment for Postoperative Recurrent Patients-Report of a Long-Term Survivor]

We present a long-term survivor who received multidisciplinary treatment for a postoperative recurrence. A 52-year-old female who had been clinically diagnosed with primary lung cancer underwent a right lower lobectomy, middle lobe wedge resection, and lymph node dissection(ND2a-1), and was pathologically diagnosed with primary pulmonary papillary adenocarcinoma( pT3N0M0, Stage ⅡB)positive for a sensitizing EGFR mutation(L858R). The patient was given UFT as postoperative adjuvant chemotherapy for 2 years. During the follow-up, multiple pulmonary metastases occurred in postoperative month 44. Gefitinib was administered as the first-line treatment, which resulted in a complete response for 30 months. Then, stereotactic radiotherapy was administered for 3 brain metastases, and multiple pulmonary metastases were treated with cisplatin plus pemetrexed and carboplatin plus pemetrexed for PD, but an adverse event occurred. Therefore, pemetrexed monotherapy was administered as a fourth-line treatment for 5 months. Then, afatinib, nivolumab, docetaxel, osimertinib, S-1, pembrolizumab, and atezolizumab(11th-line treatment)were administered with each PD or new lesion. Finally, the best supportive care was administered and she died on postoperative month 134, which was post-recurrent month 90.