Zhang Yunchao, Yin Shiqiang, Jia Yingjie, Qin Lei
Department of Oncology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine.
Administration Department, Sinopharm Group Tianjin Co., Ltd.
Medicine (Baltimore). 2020 Aug 14;99(33):e21600. doi: 10.1097/MD.0000000000021600.
Apatinib is a novel anti-angiogenic agent that targets vascular endothelial growth factor receptor-2, and is effective in patients with advanced lung cancer who are refractory to first-line chemotherapy. However, there are limited reports on concurrent apatinib therapy with iodine-125 radioactive seeds brachytherapy in elderly patients with advanced lung cancer.
We describe the first reported case of a 70-year-old woman with advanced lung cancer (T3N3M1, stage IV) who received concurrent apatinib and iodine-125 radioactive seeds brachytherapy after the failure of platinum-based doublet chemotherapy DIAGNOSIS:: The patient was diagnosed with left lower lung cancer with mediastinal lymph node metastasis by chest computed tomography.
Initially, apatinib alone was used as second-line cancer therapy. Subsequently, the patient received concurrent apatinib and iodine-125 radioactive seeds brachytherapy.
The patient achieved partial response shortly after undergoing treatment with only apatinib. During the treatment, the tumor continued to respond to apatinib therapy, and the lung metastases were diminished eventually. However, a chest computed tomography scan showed a large cavity in the lung tumor. Thereafter, the patient received concurrent apatinib and iodine-125 radioactive seeds brachytherapy. Unfortunately, she died due to pulmonary infection.
Apatinib alone may be a good second-line therapy for advanced lung cancer patients who are refractory to platinum-based doublet chemotherapy. However, its potential benefits, especially as combination therapy, need further investigation by future prospective clinical studies. Elderly patients with advanced lung cancer may benefit from concurrent apatinib with iodine-125 radioactive seeds brachytherapy when chemotherapy is not tolerated or effective. Further studies are needed to investigate the clinical outcomes and toxicities associated with concurrent apatinib and radiation therapy in patients with advanced lung cancer.
阿帕替尼是一种新型抗血管生成药物，靶向血管内皮生长因子受体-2，对一线化疗难治的晚期肺癌患者有效。然而，关于阿帕替尼与碘-125放射性粒子近距离治疗联合用于老年晚期肺癌患者的报道有限。
我们报道首例70岁晚期肺癌（T3N3M1，IV期）女性患者，在铂类双药化疗失败后接受阿帕替尼与碘-125放射性粒子近距离治疗联合方案。
通过胸部计算机断层扫描诊断患者为左肺下叶癌伴纵隔淋巴结转移。
最初，单独使用阿帕替尼作为二线抗癌治疗。随后，患者接受阿帕替尼与碘-125放射性粒子近距离治疗联合方案。
患者仅接受阿帕替尼治疗后不久即获得部分缓解。治疗期间，肿瘤持续对阿帕替尼治疗有反应，肺转移灶最终缩小。然而，胸部计算机断层扫描显示肺肿瘤内有一个大空洞。此后，患者接受阿帕替尼与碘-125放射性粒子近距离治疗联合方案。不幸的是，她因肺部感染死亡。
对于对铂类双药化疗难治的晚期肺癌患者，单独使用阿帕替尼可能是一种较好的二线治疗方法。然而，其潜在益处，尤其是作为联合治疗的益处，需要未来前瞻性临床研究进一步探究。当化疗不耐受或无效时，老年晚期肺癌患者可能从阿帕替尼与碘-125放射性粒子近距离治疗联合方案中获益。需要进一步研究来探究晚期肺癌患者阿帕替尼与放射治疗联合方案的临床疗效和毒性。
