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放疗联合细胞因子诱导的杀伤细胞疗法治疗直肠癌肝转移:一例报告

Radiotherapy combined with cytokine-induced killer cell therapy for liver metastasis from rectal cancer: A case report.

作者信息

Dang Yazheng, Qi Tao, Gao Hongxiang, Huang Shigao

机构信息

Department of Radiation Oncology, 986 Hospital of People's Liberation Army Air Force.

Department of Radiotherapy Oncology, Chang An Hospital, Xi'an, Shaan Xi.

出版信息

Medicine (Baltimore). 2019 Oct;98(43):e17636. doi: 10.1097/MD.0000000000017636.

Abstract

RATIONALE

Colorectal cancer is the most common type of cancer leading to death; approximately 10% to 25% of rectal cancer patients present with synchronous colorectal liver metastases. However, the management of synchronous colorectal liver metastases is difficult, especially for patients unable to tolerate chemotherapy or surgery. To date, the optimum treatment of colorectal liver metastasis patients remains controversial, and the curative effect is unsatisfactory. Therefore, we established a novel therapeutic approach to treat colorectal liver metastases employing radiotherapy plus immunotherapy.

PATIENT CONCERNS

A 56-year-old man presented with mucous bloody defecation occurring >20 times a day and accompanied by fatigue and poor appetite. After 4 months, he was admitted to the hospital due to increased fecal blood volume.

DIAGNOSIS

Highly differentiated adenocarcinoma was diagnosed based on rectal biopsy, and abdominal computed tomography (CT) showed multiple metastatic tumors in the liver.

INTERVENTIONS

The patient underwent 1 cycle of chemotherapy, which was terminated owing to severe gastrointestinal reactions. Several days later, he was administered cytokine-induced killer (CIK) cell therapy plus adjuvant radiotherapy.

OUTCOMES

Dynamic changes in the patient's tumor markers returned to normal levels, and abdominal CT and abdominal magnetic resonance imaging (MRI) revealed no metastatic liver tumors.

LESSONS

Sequent therapy provided a curative effect for liver metastasis in a rectal cancer patient. Radiation may have activated the body to produce distant effects, eliminating the live metastasis. CIK cell-immunotherapy and radiotherapy may have synergistic therapeutic effects and could be combined for successful treatment of liver metastasis from rectal cancer.

摘要

理论依据

结直肠癌是导致死亡的最常见癌症类型;约10%至25%的直肠癌患者会出现同时性结直肠癌肝转移。然而,同时性结直肠癌肝转移的治疗具有挑战性,尤其是对于无法耐受化疗或手术的患者。迄今为止,结直肠癌肝转移患者的最佳治疗方案仍存在争议,且疗效不尽人意。因此,我们建立了一种采用放疗加免疫疗法治疗结直肠癌肝转移的新治疗方法。

患者情况

一名56岁男性,出现每天排便>20次的黏液血便,并伴有乏力和食欲减退。4个月后,因便血增多入院。

诊断

根据直肠活检诊断为高分化腺癌,腹部计算机断层扫描(CT)显示肝脏有多个转移瘤。

干预措施

患者接受了1个周期的化疗,但因严重的胃肠道反应而终止。几天后,给予细胞因子诱导的杀伤(CIK)细胞治疗加辅助放疗。

结果

患者肿瘤标志物的动态变化恢复到正常水平,腹部CT和腹部磁共振成像(MRI)显示无肝脏转移瘤。

经验教训

序贯治疗为一名直肠癌肝转移患者带来了疗效。放疗可能激活机体产生远隔效应,消除肝转移。CIK细胞免疫治疗和放疗可能具有协同治疗作用,联合应用可成功治疗直肠癌肝转移。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f3c/6824631/2b2afdfab112/medi-98-e17636-g001.jpg

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