1、,Case report,2014.3.15 孙嘉阳,Chief Complaint:Intermittent cough for 1 year，with bloody sputum 20 days,History of present illness:Patient has been cough sputum for about 1 year with no obvious Incentives.His sputum was White foamy sputum and when patient walking fast ,cough was obviously increased whil
2、eas a little rest can be bebefit for cough cutting .These symptoms appear intermittently with no formal diagnosis.Patient coughed bloody sputum 20days ago and a chest CT at local hoapital reported :Left lower lobe mass, consider lung cancer.,Past medical history: previously healthy, no history of tu
3、berculosis and no history of chronic bronchitis, no food, drug allergies, no history of trauma, surgery,Personal history: smoking 20cigarettes per day with 40years history, drinking Irregular.,Obstetrical history: married, sterile a son. Family history: family health, no hepatitis, tuberculosis pati
4、ents without hypertension, diabetes, non-hereditary disease.,CT examination,CT examination,CT examination,CT examination,CT examination,CT examination,Electronic bronchoscopy examination,左肺下叶可见腔内肿物，累及左主支气管直至距隆突4个软骨环处，管腔部分堵塞,Pathological diagnosis,Adenocarcinoma,EGFR gene mutation detection,EGFR gene
5、 mutation detection,The treatment principles,Icotinib 125mg Tid po,CT examination after two months,CT examination after two months,CT examination after two months,CT examination after two months,CT examination after two months,CT examination after two months,Contrast,Before treatment After treatment
6、,Contrast,Electronic bronchoscopy examination,左肺下叶可见腔内肿物，累及左主支气管直至距隆突7个软骨环处，管腔部分堵塞,Contrast,The treatment principles,2. Surgical operationThe surgical indications were performedLeft pneumonectomy surgery(2013.08.06)Removal part of esophageal muscularis and part of the pericardium 3. Local chemothera
7、pyRefused 4.Continue Icotinib treatment,Pathological diagnosis,Moderately differentiated adenocarcinoma 2*1.5*1.5 Bronchial stump（-） 4L(0/2)、5(0/2)、6(0/2)、7(2/10)、8(0/1)、10(1/4)pT3N2M0 A,Follow-up,Continuous administration Icotinib and reviewing monthly Without local recurrence and metastasis,Conclu
8、sion,The advanced administration of targeted medicine can reduce the risk and difficulty of surgery,Discussion,1.Targeted medicine mainly be used for patients with locally advanced lung cancer who has been received prior chemotherapy or metastatic non-small cell lung cancer patients Targeted medicine can be another option of neoadjuvant? 2.Male patients with a history of smoking also benefit from targeted medicine,Thank you for attention,
