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化疗放疗联合自然杀伤细胞转移治疗复发性和转移性鼻咽癌患者并实现长期肿瘤控制:一例报告

Chemoradiotherapy combined with NK cell transfer in a patient with recurrent and metastatic nasopharyngeal carcinoma inducing long-term tumor control: A case report.

作者信息

Jin Yuan-Yuan, Yang Wen-Zhuo, Zou Sen, Sun Zheng-Yang, Wu Chun-Tao, Yang Zhao-Yong

机构信息

NHC Key Laboratory of Biotechnology of Antibiotics, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences, Beijing.

Sun Yat-sen University School of Medicine, Guangzhou.

出版信息

Medicine (Baltimore). 2020 Oct 23;99(43):e22785. doi: 10.1097/MD.0000000000022785.

Abstract

RATIONALE

Nasopharyngeal carcinoma (NPC) is one of the most common malignancies in Southern China. Although combined chemotherapy with radiotherapy has been widely used in treating locally advanced lesions, relapse and metastases remain the primary cause of treatment failure, and are associated with an extremely poor prognosis. Therefore, more efficient and milder therapies are needed.

PATIENT CONCERNS

Herein, we report a patient with advanced NPC with intracranial metastases who showed progression during conventional treatment.

DIAGNOSES

Nonkeratinizing undifferentiated nasopharyngeal carcinoma (stage IV).

INTERVENTIONS

After the completion of initial chemoradiotherapy and targeted therapy, metastases to brain occurred during follow-up. Ex vivo-cultured allogeneic NK cell infusion was offered.

OUTCOMES

Although the intracranial metastases did not decrease 10 months after the NK cell treatment, they decreased significantly at 31 months after the treatment and partially disappeared. The tumor response indicated partial response. Furthermore, all of the intracranial metastases continued to decrease at about 42 months after treatment.

LESSONS

The brain metastases of NPC are rare with poor prognosis. Radiotherapy in NPC can disrupt the blood-brain barrier, which may contribute to the metastases of brain. This case report will provide rationale for NK cell infusion following regular chemoradiotherapy.

摘要

理论依据

鼻咽癌(NPC)是中国南方最常见的恶性肿瘤之一。尽管化疗联合放疗已广泛应用于局部晚期病变的治疗,但复发和转移仍然是治疗失败的主要原因,且预后极差。因此,需要更有效、更温和的治疗方法。

患者情况

在此,我们报告一例晚期鼻咽癌伴颅内转移患者,该患者在常规治疗期间病情进展。

诊断

非角化未分化鼻咽癌(IV期)。

干预措施

在完成初始放化疗和靶向治疗后,随访期间出现脑转移。给予体外培养的异体自然杀伤(NK)细胞输注。

结果

虽然NK细胞治疗10个月后颅内转移灶未减少,但治疗31个月时显著减少且部分消失。肿瘤反应显示为部分缓解。此外,治疗约42个月时所有颅内转移灶持续减少。

经验教训

鼻咽癌脑转移罕见且预后差。鼻咽癌放疗可破坏血脑屏障,这可能促使脑转移。本病例报告将为常规放化疗后NK细胞输注提供理论依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3698/7581140/6a7da8272596/medi-99-e22785-g001.jpg

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