1、Case report Chief Complaint:Intermittent cough for 1 year，with bloody sputum 20 daysHistory 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 whileas a little rest
2、 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 tuberculosis and no histo
3、ry of chronic bronchitis,no food,drug allergies,no history of trauma,surgeryPersonal history:smoking 20cigarettes per day with 40years history,drinking Irregular.Obstetrical history:married,sterile a son.Family history:family health,no hepatitis,tuberculosis patients without hypertension,diabetes,no
4、n-hereditary disease.CT examinationCT examinationCT examinationCT examinationCT examinationCT examinationElectronic 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 diagnosisAdenocarcinomaEGFR gene mutation detectionEGFR gene mutation detectionThe treatment principlesIcotini
5、b 125mg Tid po CT examination after two monthsCT examination after two monthsCT examination after two monthsCT examination after two monthsCT examination after two monthsCT examination after two months ContrastContrast Before treatment After treatment ContrastContrastElectronic bronchoscopy examinat
6、ion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 ContrastThe treatment principlesThe treatment principles2.Surgical operation2.Surgical operation The surgical indications were performedThe surgical indications were performed Left pneumonectomy surgery(2013.08.06)Left pneumonectomy surgery(2013.08.06
7、)Removal part of esophageal muscularis and part Removal part of esophageal muscularis and part of the pericardiumof the pericardium3.Local chemotherapy3.Local chemotherapy Refused Refused4.Continue Icotinib treatment 4.Continue Icotinib treatment Pathological diagnosisModerately differentiated adeno
8、carcinoma 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 AFollow-upContinuous administration Icotinib and Continuous administration Icotinib and reviewing monthlyreviewing monthlyWithout local recurrence and metastasisWithout local recurrence and metastasisConclusion
9、ConclusionThe advanced administration of targeted The advanced administration of targeted medicine can medicine can reduce the risk and reduce the risk and difficulty difficulty of surgeryof surgeryDiscussion1.1.Targeted medicine Targeted medicine mainly be used for mainly be used for patients with
10、locally advanced lung cancer patients with locally advanced lung cancer who has been received prior chemotherapy who has been received prior chemotherapy or metastatic non-small cell lung cancer or metastatic non-small cell lung cancer patientspatientsTargeted medicine can be Targeted medicine can be another another option ofoption of neoadjuvant?neoadjuvant?2.Male patients with a history of smoking 2.Male patients with a history of smoking also benefit from talso benefit from targeted medicineargeted medicineThank you for attention
