Arias Ron David, Labandeira Carmen M, Cameselle García Soledad, García Mata Jesús, Salgado Fernández Mercedes
Medical Oncology Department, University Hospital Complex of Ourense, Ourense, Spain.
Neurology Department, University Hospital Complex of Vigo, Hospital Alvaro Cunqueiro, Pontevedra, Spain.
Case Rep Oncol. 2020 Feb 4;13(1):69-75. doi: 10.1159/000505237. eCollection 2020 Jan-Apr.
In a patient who had been diagnosed in 2006 with appendiceal adenocarcinoma with peritoneal metastases after an incomplete surgery, palliative chemotherapy was administered. First-line treatment with 5-fluorouracil, leucovorin and oxaliplatin (FOLFOX) and second-line treatment including 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) plus panitumumab showed inefficiency in controlling disease progression. Third-line chemotherapy combining capecitabine plus bevacizumab was started, achieving good control of the tumour growth and a minor response in the second computed tomography scan. We decided to maintain the treatment, although forced bevacizumab "breaks" were necessary due to unexpected adverse events, with the patient suffering disease progression every time bevacizumab was stopped and reaching minor response again once the antiangiogenic treatment was reintroduced. During more than 10 years after starting third-line treatment, the patient maintained good performance status and disease stability with this "up and down" management until January 2019, when a neurological adverse event during bevacizumab infusion drove us to abandon it definitely.
一名患者在2006年接受不完全手术后被诊断为阑尾腺癌伴腹膜转移，随后接受了姑息化疗。一线使用氟尿嘧啶、亚叶酸钙和奥沙利铂（FOLFOX）治疗，二线使用氟尿嘧啶、亚叶酸钙和伊立替康（FOLFIRI）联合帕尼单抗治疗，均未能有效控制疾病进展。开始三线化疗，联合卡培他滨和贝伐单抗，在第二次计算机断层扫描中实现了对肿瘤生长的良好控制和轻微缓解。我们决定维持治疗，尽管由于意外不良事件需要暂停贝伐单抗，但每次停止使用贝伐单抗时患者都会出现疾病进展，重新引入抗血管生成治疗后又会再次出现轻微缓解。在开始三线治疗后的10多年里，通过这种“停停走走”的管理方式，患者保持了良好的身体状况和疾病稳定，直到2019年1月，贝伐单抗输注期间发生的一次神经不良事件促使我们彻底停用了它。
