Successful Concurrent Chemoradiotherapy for Limited-Stage Small Cell Lung Cancer in a Patient with Combined Pulmonary Fibrosis and Emphysema: A Case Report.

Interstitial lung disease (ILD) is a major risk factor for severe radiation pneumonitis (RP) during thoracic radiotherapy. We herein report a case of limited-stage small cell lung cancer with coexisting pulmonary fibrosis and emphysema treated with concurrent chemoradiotherapy. The patient exhibited fibrotic lesions consistent with a usual interstitial pneumonia pattern and a mild 18F-fluorodeoxyglucose uptake, indicating an elevated risk of RP. However, high-grade RP did not develop, likely because radiation exposure to nontarget lungs was limited. The irradiation field was spatially separated from the fibrotic regions. This case suggests that carefully selected patients with ILD may tolerate concurrent chemoradiotherapy.