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Marked Tumor Response and Fatal Hemoptysis During Radiation for Lung Cancer in a Human Immunodeficiency Virus-Positive Patient Taking Nelfinavir  Christopher.

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Presentation on theme: "Marked Tumor Response and Fatal Hemoptysis During Radiation for Lung Cancer in a Human Immunodeficiency Virus-Positive Patient Taking Nelfinavir  Christopher."— Presentation transcript:

1 Marked Tumor Response and Fatal Hemoptysis During Radiation for Lung Cancer in a Human Immunodeficiency Virus-Positive Patient Taking Nelfinavir  Christopher H. Chapman, BA, John Shen, BS, Edith J. Filion, MD, Phuoc T. Tran, MD, PhD, Wendy Hara, MD, Alfredo Asuncion, MD, Daniel Marko, MD, Heather Wakelee, MD, Gerald J. Berry, MD, Kevin W. Dimmick, Billy W. Loo, MD, PhD, Jon Green, MD, PhD  Journal of Thoracic Oncology  Volume 4, Issue 12, Pages (December 2009) DOI: /JTO.0b013e3181bf111d Copyright © 2009 International Association for the Study of Lung Cancer Terms and Conditions

2 FIGURE 1 A, Pretreatment axial positron emission tomography-computed tomography (PET-CT) image showing the hypermetabolic left upper lung tumor (arrow) and subcarinal lymph node (arrowhead). B, Axial CT image with dose distribution (at or above the prescription dose) superimposed. The maximum point dose is 84.5 Gy and is located in the subcarinal lymph node target. A small area of cavitation is already present before starting radiation. C, Axial CT image after nine fractions (18 Gy) of intensity-modulated radiation therapy (IMRT), demonstrating decrease in tumor size, and enlargement of an area of central cavitation tracking into the left main bronchus (arrow). Journal of Thoracic Oncology 2009 4, DOI: ( /JTO.0b013e3181bf111d) Copyright © 2009 International Association for the Study of Lung Cancer Terms and Conditions

3 FIGURE 2 A, Endobronchial biopsy showing invasive squamous cell carcinoma. Scale bar 50 μm. B, Postmortem histology. Microscopic section of lung tumor from the necrotic cavity. Extensive tumor necrosis and microscopic residual squamous cell carcinoma (arrow) with radiation-induced changes (arrowhead) are seen. Scale bar 50 μm. C, Left lung at autopsy. A 7 × 4 × 4 cm necrotic cavity is present at the hilum. A probe is passed from the main bronchus into the cavity through a 1.5 × 1.5 cm erosion. Journal of Thoracic Oncology 2009 4, DOI: ( /JTO.0b013e3181bf111d) Copyright © 2009 International Association for the Study of Lung Cancer Terms and Conditions

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