Curative intent therapy in oligometastatic lung cancer with an unresectable primary with N3 nodes: case report and review of the literature.

Untreated NSCLC patients with brain metastases have a median survival of approximately 2 months; locally advanced stage III NSCLC patients treated with chemoradiation have a median survival of 16-19 months. Select patients with oligometastatic disease may have a prolonged survival if managed aggressively. We present the case of a 47-year-old woman with lung adenocarcinoma, cT2aN3M1a, (supraclavicular lymph node, solitary brain metastasis). She underwent brain metastasectomy, whole brain radiation, induction chemotherapy and concurrent chemoradiotherapy. She relapsed in the brain and locoregionally and was treated with brain re-irradiation, and systemic chemotherapy. Her progression-free survival was 32 months and she is alive with recurrent disease 63 months after diagnosis. Systemic therapy is an important tool in the multimodality management of patients with oligometastatic disease.