Methods
Based on the above results, the patient’s diagnosis is:
1. Left lung squamous cell carcinoma, pT3N0M0, Stage IIB.
2. Secondary pulmonary tuberculosis, smear-negative, culture results pending, molecular biology test positive, undergoing initial treatment.
The patient began anti-tuberculosis treatment on April 8, 2023, following the recommendations from the tuberculosis department’s consultation. Anti-tuberculosis regimen is as follows: Rifapentine capsules 0.45g, twice a week; Isoniazid tablets 0.3g, once daily; Ethambutol tablets 0.75g, once daily; Levofloxacin tablets 0.5g, once daily. Close monitoring of liver and kidney functions, as well as blood analyses, are essential during treatment.
Additionally, the patient underwent palliative radiotherapy for lung cancer on April 17, 2023, with the detailed plan as follows: Planning Target Volume (PTV): 6000cGy in 30 fractions, Gross Tumor Volume for lymph nodes (GTVnd): 6000cGy in 30 fractions. The plan was divided into two stages: the first stage was 5000cGy in 25 fractions for both PTV and GTVnd; the second stage was 1000cGy in 5 fractions for both PTV and GTVnd (Figure 2: Radiotherapy plan ABCD). The patient will continue anti-tuberculosis treatment during the radiotherapy period.
On August 1th, 2023, the patient entered the consolidation treatment phase. The anti-tuberculosis treatment plan is: Rifapentine capsules 0.45g, twice a week; Isoniazid tablets 0.3g, once daily; Ethambutol 0.75g, once daily.
The patient underwent four cycles of chemotherapy with the TC regimen on August 5th and August 26th and October 17th and November 7th, 2023, respectively. The specific drug dosages were: Paclitaxel 135mg/m2 + Carboplatin (ACU: 5, once every 21 days).