1.     Rakesh, 55 years old, had weakness and partial seizures right upper limb since December 2010. MRI brain was left posterior Frontal intrinsic tumor with a suspected left lung lesion.



2.     He underwent surgery - left posterior frontal craniotomy and gross total excision of tumor on 01/02/2011 at Max Hospital, Saket, Delhi. Histopathology revealed it malignant round cell tumor s/o metastatic cranial lesion. Biopsy (left frontal mass) was positive for CK7, EMA and negative for TTF1 and vimentin s/o metastatic adenocarcinoma.



3.     Subsequently, Bronchoscopy was done on 22nd Feb & showed narrowed anterior segment left lower lobe.



4.     Transbronchial biopsy, BAL Fluid and transbronchial needle aspiration was done on 23rd Feb 2011 s/o non small cell lung carcinoma (NSCLC) stage IV favoring adenocarcinoma.



5.     EGFR gene mutations in exon 18,19,20 and 21 were not detected which was done at Reliance Life Sciences Pvt. Ltd. Mumbai



6.     Chemotherapy was started at Rajiv Gandhi Cancer Research Hospital (RGCH), Delhi on 3rd March 2011 with six (6) cycles of chemotherapy; Pemetrexes and cisplatin given and completed on 24/06/11. Every Chemo cycle the following treatment was given:

•     Cap Empow 125mg PO stat ; Inj Pazen 0.25mg stat

•     Inj Emset 8mg+inj Dexona 8mg +Inj Aciloc 50mg in 100ml NS

•     Inj Alimta 800mg in 100ml NS IV ;

•     Inj Cisplatin 60-60mg in 500ml NS IV d1-2

•     Inj MsSO4 50% 1 amp in 500ml NS IV ; One vac Ns IV

•     Tan Survi 1 mg OD , Tab Facid 20 mg BD



7.     Doctors of RGCH have advised to take 3 months rest for chemotherapy(CT) after that they will be decide be 2nd line of treatments or any other options.



8.     Five RT to brain (20 Gy) and one RT to L3-S1 ( 8Gy) completed during 8-12th August, 2011 in AIIMS.



9.     Now, I am on Alimta Maintenance First cycle has completed after RT.



Advice me weather my treatment is going right track or not

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