Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical College, No. 151, Yanjiang Rd, Guangzhou, 510120, China.
J Thorac Dis. 2012 Jun 1;4(3):316-9. doi: 10.3978/j.issn.2072-1439.2012.03.20.
This is the case of a 63 year-old male who was diagnosed adenocarcinoma in the left upper lung with ipsilateral malignant pleural effusion. At diagnosis it had already spread to left pulmonary HLN (hilar lymph node) and left supraclavicular lymph node and mediastinal lymph nodes. The patient received combined chemotherapy with bevacizumab and GP (gemcitabine and carboplatin) for 6 courses. Disease progression on chest CT scan was recognized, daily treatment with oral gefitinib (250 mg/day) was commenced. One week later, he was admitted under the impression of gefitinib-related interstitial pneumonitis, gefitinib was discontinued immediately and methylprednisolone with BIPAP assisted ventilation were used. The patient was followed up for 2 months after the start of treatment with corticosteroids and BIPAP assisted ventilation and remained well.
这例患者为 63 岁男性，诊断为左肺上叶腺癌伴同侧恶性胸腔积液。初诊时已发生左侧肺门淋巴结（HLN）和左锁骨上淋巴结及纵隔淋巴结转移。患者接受贝伐珠单抗联合 GP（吉西他滨和顺铂）化疗 6 个疗程。胸部 CT 扫描发现疾病进展，开始每日口服吉非替尼（250mg/天）治疗。一周后，因疑似吉非替尼相关间质性肺炎入院，立即停用吉非替尼，给予甲泼尼龙联合 BIPAP 辅助通气。开始皮质激素和 BIPAP 辅助通气治疗后，患者随访 2 个月，病情稳定。
