Metastatic Ca Lung with liver and brain metastasis with Distal Brain Failure was treated successfully with Re-SRS to brain metastasis.

About the Patient

A 60+ year old gentleman, diagnosed case of Metastatic Ca Lung (T790M EGFR +ve) with Liver and Brain Metastasis was presented at the OPD with complaints of Slurring of speech along with weakness in right half of the body along with Headache and behavioral changes of 10-15 days duration.

Case Scenario

Patient has previously been treated with SRS for Brain Metastasis in October 2021 and was on Osimertinib (Anti-EGFR Therapy) when he developed above mentioned complaints. Upon evaluation, MRI Brain revealed that previously treated Brain metastasis was still controlled but 4 new metastatic lesions had appeared in Brain (Distal Brain Failure). He kept taking medications as per advice of local practitioner but got no relief and eventually consulted Dr. Farhan Ahmad, Consultant Radiation Oncology at Apollomedics Super Specialty Hospital, Lucknow.

Patient was advised to undergo Repeat Stereotactic Radiosurgery / Stereotactic Radiotherapy (Re-SRS) for the new metastatic lesions in Brain along with Medical Decompression and Anti-epileptics. After thorough Radiation Treatment Planning, the patient received state of the art Repeat Stereotactic Radiosurgery treatment (Re-SRS) under Dr. Farhan Ahmad using Truebeam Medical Linear Accelerator (LINAC) using a total dose of 30Gy in 05fractions given on alternate days to all the Brain Metastatic lesions along with Simultaneous Whole Brain RT (20Gy in 05fractions) with Hippocampus Avoidance (to prevent Neurocognitive decline). He tolerated the treatment well without any significant toxicity. Response Evaluation MRI revealed that all metastatic lesions have completely resolved in the
brain. 6 months post treatment, patient is free of any symptoms pertaining to Brain Metastasis.

Worldwide Scenario

Stereotactic Radiosurgery is the worldwide standard treatment for multiple brain metastasis whereas Whole Brain Radiotherapy (WBRT) along with SRS may prevent Distal Brain Failure. Hippocampus Avoidance along with WBRT helps in prevention of Neurocognitive decline due to radiation treatment to Brain.

Expertise at Apollomedics Hospital, Lucknow

Dr. Farhan Ahmad is a Consultant Radiation Oncology at Apollomedics Super Specialty Hospital, Lucknow. He has expertise in treating Cranial and Extracranial Malignant and Non-Malignant lesions with SRS and SBRT. Apollomedics Super Specialty Hospital, Lucknow is equipped with Truebeam LINAC, a cutting edge technology required for delivering SRS / SBRT. The treatment is usually well tolerated in expert hands.

Patient Testimonial

Patient is extremely thankful to the Radiation Oncology team at Apollomedics Super Specialty Hospital, Lucknow for his successful treatment.