Meng DU, Chai Yan-Lan, He Yin-Fang, Hu Honglian, Liu Rui, Liu Zi
Department of Radiotherapy Oncology, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shaanxi 710061, P.R. China.
Department of Gynaecology, Shangluo Central Hospital, Shangluo, Shaanxi 726000, P.R. China.
Oncol Lett. 2014 Jul;8(1):82-84. doi: 10.3892/ol.2014.2061. Epub 2014 Apr 11.
Solid tumors following myelodysplastic syndrome (MDS) are rare and have no uniform treatment guidelines. The current study presents a rare case of a 47-year-old female diagnosed with cervical cancer (International Federation of Gynecology and Obstetrics stage IIIB) with an eight-year history of MDS. A multidisciplinary treatment discussion was organized and a rigorous treatment plan was developed. With injection of granulocyte colony-stimulating factor and interleukin-11 factor, transfusion of red blood cell suspension and close monitoring of the blood count, the patient was administered radiotherapy, specifically intensity modulated radiation therapy. However, a degree IV bone marrow suppression repeatedly assaulted, leading to interruption of the radiotherapy treatment. Eventually, the total dose received by point A (2 cm above the cervical os marker and 2 cm perpendicular to the uterine axis along the plane of the uterus) was 51 Gy. One month later, a gynecological examination and magnetic resonance imaging of the pelvis revealed that the treatment resulted in a complete remission. In conclusion, radiation therapy can still be implemented to obtain satisfactory local control when the hematopoietic function of the bone marrow is weakened due to long-term MDS.
骨髓增生异常综合征（MDS）后继发实体瘤较为罕见，且尚无统一的治疗指南。本研究报告了一例罕见病例，一名47岁女性，诊断为宫颈癌（国际妇产科联盟III B期），有八年的MDS病史。组织了多学科治疗讨论并制定了严格的治疗方案。通过注射粒细胞集落刺激因子和白细胞介素-11因子、输注红细胞悬液以及密切监测血细胞计数，对患者进行了放射治疗，具体为调强放射治疗。然而，患者多次出现IV度骨髓抑制，导致放射治疗中断。最终，A点（宫颈口标记上方2 cm且沿子宫平面垂直于子宫轴2 cm处）接受的总剂量为51 Gy。一个月后，妇科检查和盆腔磁共振成像显示治疗取得了完全缓解。总之，当长期MDS导致骨髓造血功能减弱时，仍可实施放射治疗以获得满意的局部控制效果。
