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阴道黏膜黑色素瘤:免疫治疗及“0-7-21”放疗方案(24 Gy/3次分割/21天)后完全缓解

Vaginal Mucosal Melanoma: a Complete Remission after Immunotherapy and '0-7-21' Radiotherapy Regimen (24 Gy/3 fractions/21 days).

作者信息

Parisi Silvana, Lillo Sara, Cacciola Alberto, Santacaterina Anna, Palazzolo Carmela, Platania Angelo, Settineri Nicola, Franchina Tindara, Tamburella Consuelo, Pergolizzi Stefano

机构信息

REM Radioterapia, Viagrande, Italy.

University of Messina, Messina, Italy.

出版信息

Folia Med (Plovdiv). 2020 Sep 30;62(3):605-609. doi: 10.3897/folmed.62.e49926.

Abstract

We present the case of a patient with vaginal mucosal melanoma who underwent complete remission after immunotherapy and '0-7-21' radiotherapy regimen (24 Gy/3 fractions/21 days). An 80-year-old woman had a biopsy of a voluminous vaginal lesion and received a histological diagnosis of melanoma with angiomatoid aspects. The patient underwent immunotherapy with pembrolizumab 2 mg/kg every 3 weeks and was sent to our attention for planning radiotherapy as the extent of the lesion did not make it susceptible to surgery.Considering the concomitant administration of pembrolizumab, we chose to treat this patient with a modulated intensity radiation therapy technique delivering a hypofractionated dose of 24 Gy in 3 fractions delivered on days 0, 7, and 21. We observed a complete clinical remission of the melanoma 12 months after radiotherapy and she has been alive for 18 months with no clinical signs of local recurrence.

摘要

我们报告了一例阴道黏膜黑色素瘤患者的病例,该患者在接受免疫治疗和“0-7-21”放疗方案(24 Gy/3次分割/21天)后完全缓解。一名80岁女性对一个巨大的阴道病变进行了活检,组织学诊断为具有血管瘤样特征的黑色素瘤。该患者每3周接受一次2 mg/kg的帕博利珠单抗免疫治疗,由于病变范围使其不适合手术,故转至我院进行放疗规划。考虑到同时使用帕博利珠单抗,我们选择采用调强放射治疗技术对该患者进行治疗,在第0、7和21天分3次给予24 Gy的低分割剂量。放疗12个月后,我们观察到黑色素瘤完全临床缓解,患者已存活18个月,无局部复发的临床迹象。

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