PMC9449808_01
Serial CT's of the chest shows resolution of lung pneumonitis with anabolic steroids. (A) Lung disease at presentation and after completion of definitive chemoRT at (B), 2 months (C), 5 months (D), 8 months (E), 11 months (F), 17 months. The androgen-HGH regimen was initiated after the 12 month scan, (E).
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CT of the chest showed a 7 cm mass in the right lower lobe of the lung with enlarged subcarinal lymph nodes ( Figure 1A ). CT Chest 2 months post radiation completion showed shrinkage of the primary mass to 4.4 cm, reduction in the size of involved lymph nodes and associated radiation changes in the surrounding lung ( Figure 1B ). His symptoms persisted despite therapy and repeat imaging 3 months later showed opacities within the high and intermediate areas of radiation dose consistent with pneumonitis ( Figure 1C ). CT of the chest 17 months post radiation therapy showed consolidation of the treated lobe and resolution of pneumonitis elsewhere in the lung ( Figure 1F ).
PET/CT showing FDG-avid R hilar and subcarinal lymph nodes.
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PET/CT showed FDG uptake in the lung mass and right hilar and subcarinal lymph nodes ( Figure 2 ), but no evidence of metastatic disease. Pre-treatment pulmonary function tests revealed a FVC of 66% and FEV1 of 59%.
Radiation treatment plan. Representative axial, sagittal, and coronal slices for R lung lesion and mediastinal disease treated to 60 Gy in 30 fractions with concurrent carboplatin and paclitaxel.
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He was treated with chemoradiation to a dose of 6000 cGy in 30 fractions ( Figure 3 ) with 6 cycles of carboplatin and paclitaxel given weekly.