71 yr old female

Presented with shortness of breath

Past medical history – high blood pressure, ischemic heart disease 10 years ago

WHO PS1

PFT- FEV1 80% predicted; KCO 105% predicted

CT thorax abdomen – right upper lobe tumor & enlarged station 4R, 7 lymph nodes T3 N2 M0

Mediastinoscopy - Station 4R adenocarcinoma PDL1 10%

PET-CT - FDG avid right supraclavicular lymph node T3 N3 M0

MR Brain - Clear

Treatment – IMRT 66 Gy in 33 fractions, concurrently with cisplatin etoposide x 2 cycles starting day 1 of radiotherapy

2 weeks post CTRT

CTCAE v5.0 Grade 3 oesophagitis, PS2

4 weeks post CTRT

CTCAE v5.0 Grade 2 oesophagitis, PS1

Decision to start durvalumab 5 weeks after completion of CRT for a duration of 12 months