Department of Thoracic Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Ann Palliat Med. 2021 Apr;10(4):4965-4969. doi: 10.21037/apm-21-708.
The 5-year survival rate of patients with stage IIIB non-small cell lung cancer (NSCLC) range is 26%. Pathological complete response (pCR) is the best outcome after treatment for stage IIIB NSCLC. For patients with stage IIIB NSCLC, concurrent chemoradiotherapy with a curative intent is currently the standard treatment. For patients who respond to treatment, this is followed by consolidation immunotherapy with durvalumab. However, because of the complex and diverse nature of stage IIIB NSCLC, standard treatment is not necessarily suitable for all patients; rather, individualized and precise treatment can maximize the benefits of patients. Herein, we report a case of a patient with stage IIIB lung squamous cell carcinoma (SCC) treated with neoadjuvant chemoradiotherapy after receiving all 6 cycles of treatment, the patient underwent video-assisted thoracoscopic surgery (VATS) right upper lobectomy, right middle partial lobectomy, right lower partial lobectomy, and systematic mediastinal lymph node dissection. Postoperative pathological section results showed a pCR. The patient did not continue to use immunotherapy as a consolidation treatment after surgery. He remained disease free until the latest follow-up a half year later. This case has led us to doubt whether immunotherapy with durvalumab is still needed for patients with pCR. However, more clinical trials are needed to provide stronger evidence.
Ⅲ B 期非小细胞肺癌（NSCLC）患者的 5 年生存率为 26%。病理完全缓解（pCR）是治疗Ⅲ B 期 NSCLC 后的最佳结果。对于Ⅲ B 期 NSCLC 患者，目前以治愈为目的的同期放化疗是标准治疗。对于治疗有反应的患者，随后用度伐利尤单抗进行巩固免疫治疗。然而，由于Ⅲ B 期 NSCLC 的复杂性和多样性，标准治疗不一定适合所有患者；相反，个体化和精确的治疗可以使患者获益最大化。在此，我们报告了一例接受 6 个周期新辅助放化疗治疗后达到 pCR 的Ⅲ B 期肺鳞癌（SCC）患者的病例。患者接受了电视辅助胸腔镜手术（VATS）右肺上叶切除术、右肺中叶部分切除术、右肺下叶部分切除术和系统性纵隔淋巴结清扫术。术后病理切片结果显示 pCR。患者手术后没有继续使用免疫疗法作为巩固治疗。直到半年后最新随访时，患者仍无疾病进展。该病例使我们怀疑 pCR 患者是否仍需要使用度伐利尤单抗进行免疫治疗。然而，需要更多的临床试验来提供更强有力的证据。
