caa a22 4500 475752295 CHVBK 20180406123527.0 cr unu---uuuuu 170329e20000601xx s 000 0 eng 10.1007/s005950070130 doi (NATIONALLICENCE)springer-10.1007/s005950070130 Long-term survival of a patient with stage IV pulmonary large cell carcinoma achieved by combined-modality therapy: Report of a case [Elektronische Daten] [Shunsuke Kobayashi, Shinichiro Okada, Toru Hasumi, Nobuyuki Sato, Shigefumi Fujimura] We describe herein the case of a 59-year-old-man with stage IV pulmonary large cell carcinoma and a giant brain metastasis, in whom two sublines with different growth characteristics and drug sensitivities in vitro were established from the primary tumor. Disease-free survival for more than 5 years after surgery was achieved by combined-modality therapy together with surgery to remove the primary tumor, radiation to the brain metastasis, and chemotherapy to presumed hematogenous dissemination. Subline 1 proliferated in a monolayer of epithelial-like cells, while subline 2 showed a floating colony pattern of proliferation, resembling the typical growth characteristics of small cell lung cancer (SCLC) cells in vitro. Subline 2 was sensitive to a number of drugs, namely, vincristine (VCR), cyclophosphamide (CPM), adriamycin (ADR), and cisplatin (CDDP), whereas subline 1 was resistant to many drugs. The patient was treated with a combination of 44 Gy of whole-brain irradiation and a number of cycles of chemotherapy comprised of ADR, VCR, and CPM, followed by CDDP, VCR, and CPM, based on the results of sensitivity testing of the subline 2 cells. As a result, the patient has been disease-free for more than 5 years postoperatively. In conclusion, this case report serves to demonstrate that meticulous combined-modality treatment taking tumor heterogeneity in human cancers into account may be necessary to achieve breakthroughs in current cancer therapy for advanced lung cancer. Springer-Verlag, 2000 lung cancer nationallicence tissue culture nationallicence heterogeneity nationallicence drugscreening assay nationallicence combined-modality therapy nationallicence Kobayashi Shunsuke Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, 980-8575, Sendai, Japan aut Okada Shinichiro Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, 980-8575, Sendai, Japan aut Hasumi Toru Sendai Kousei Hospital, 4-15 Hirosemachi, Aoba-ku, 980-0873, Sendai, Japan aut Sato Nobuyuki Sendai Kousei Hospital, 4-15 Hirosemachi, Aoba-ku, 980-0873, Sendai, Japan aut Fujimura Shigefumi Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, 980-8575, Sendai, Japan aut Surgery Today Springer-Verlag 30/6(2000-06-01), 561-566 0941-1291 30:6<561 2000 30 595 https://doi.org/10.1007/s005950070130 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s005950070130 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kobayashi Shunsuke Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, 980-8575, Sendai, Japan aut NATIONALLICENCE 700 1- Okada Shinichiro Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, 980-8575, Sendai, Japan aut NATIONALLICENCE 700 1- Hasumi Toru Sendai Kousei Hospital, 4-15 Hirosemachi, Aoba-ku, 980-0873, Sendai, Japan aut NATIONALLICENCE 700 1- Sato Nobuyuki Sendai Kousei Hospital, 4-15 Hirosemachi, Aoba-ku, 980-0873, Sendai, Japan aut NATIONALLICENCE 700 1- Fujimura Shigefumi Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, 980-8575, Sendai, Japan aut NATIONALLICENCE 773 0- Surgery Today Springer-Verlag 30/6(2000-06-01), 561-566 0941-1291 30:6<561 2000 30 595 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer