Fig. 2

A representative complete remission (CR) patient with oligometastases in stage III. A CR patient with stage III (a-i), in whom successful control of primary and oligometastatic lesions was obtained, is shown. A male in his 50s consulted our hospital due to an abnormal shadow recognized on a chest X-ray (a). The computed tomography (CT) revealed the primary lesion to be in the right middle lobe (b), as well as swelling of a right hilar (c) and a mediastinal lymph node. Positron emission tomography (PET) / CT (d) and head magnetic resonance imaging (MRI) demonstrated the patient to have stage IIIA (cT1bN2M0) adenocarcinoma. The primary lesion showed scar formation after chemotherapy (e). However, PET/CT showed viable cells in the right hilar lymph node. Three-dimensional conformal radiation therapy was planned for the right hilar and mediastinal lymph nodes (f). On the day 380 since initial treatment, PET/CT revealed recurrence of the primary lesion and a new mediastinal lymph node metastasis (g). Three-dimensional conformal radiation therapy was administered for these lesions (h). The PET/CT (i) and the head MRI demonstrated CR