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一例转移性肺腺癌长期生存超过11年的病例报告。

A case report of metastatic lung adenocarcinoma with long-term survival for over 11 years.

作者信息

Matsuzaki Tatsu, Iwami Eri, Sasahara Kotaro, Kuroda Aoi, Nakajima Takahiro, Terashima Takeshi

机构信息

Department of Respiratory Medicine, Tokyo Dental College, Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba, Japan.

出版信息

Medicine (Baltimore). 2019 Jan;98(4):e14100. doi: 10.1097/MD.0000000000014100.

Abstract

RATIONALE

This is the first known report in the English literature to describe a case of metastatic non-small cell lung cancer that has been controlled for >11 years.

PATIENT CONCERNS

A 71-year-old man visited our hospital because of dry cough.

DIAGNOSIS

Chest computed tomography revealed a tumor on the left lower lobe with pleural effusion, and thoracic puncture cytology indicated lung adenocarcinoma.

INTERVENTIONS

Four cycles of carboplatin and docetaxel chemotherapy reduced the size of the tumor; however, it increased in size after 8 months, and re-challenge chemotherapy (RC) with the same drugs was performed. Repeated RC controlled disease activity for 6 years. After the patient failed to respond to RC, erlotinib was administered for 3 years while repeating a treatment holiday to reduce side effects. The disease progressed, and epidermal growth factor receptor (EGFR) gene mutation analysis of cells from the pleural effusion detected the T790 M mutation. Therefore, osimertinib was administered, which has been effective for >1 year.

OUTCOMES

The patient has survived for >11 years since the diagnosis of lung cancer.

LESSONS

Long-term survival may be implemented by actively repeating cytotoxic chemotherapy and EGFR-tyrosine kinase inhibitor administration.

摘要

原理

这是英文文献中已知的首例描述转移性非小细胞肺癌病例被控制超过11年的报告。

患者情况

一名71岁男性因干咳前来我院就诊。

诊断

胸部计算机断层扫描显示左肺下叶有肿瘤伴胸腔积液,胸腔穿刺细胞学检查提示肺腺癌。

干预措施

四个周期的卡铂和多西他赛化疗使肿瘤缩小;然而,8个月后肿瘤增大,遂用相同药物进行再次化疗(RC)。重复RC控制疾病活动达6年。患者对RC无反应后,给予厄洛替尼治疗3年,期间反复进行治疗假期以减轻副作用。疾病进展,对胸腔积液细胞进行表皮生长因子受体(EGFR)基因突变分析检测到T790M突变。因此,给予奥希替尼治疗,已有效超过1年。

结果

自肺癌诊断以来,患者已存活超过11年。

经验教训

通过积极重复细胞毒性化疗和EGFR酪氨酸激酶抑制剂给药可实现长期生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b73/6358372/a7b68cd00709/medi-98-e14100-g001.jpg

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