帕博利珠单抗治疗晚期和复发性宫颈癌的完全缓解——3 例报告。

Complete remission of advanced and recurrent cervical cancer with pembrolizumab treatment- 3 case reports.

机构信息

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Linkou Branch, Taiwan; Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Taiwan.

Gynecologic Cancer Research Center, Chang Gung Memorial Hospital, Taiwan; Department of Radiation Oncology, Chang Gung Memorial Hospital Linkou Branch, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2021 Sep;60(5):938-941. doi: 10.1016/j.tjog.2021.07.030.

DOI:10.1016/j.tjog.2021.07.030

PMID:34507680

Abstract

OBJECTIVE

Recurrent cervical cancer is hard to treat when occurring in a previous radiated area and unresectable or distant metastasis. We present three such cases who achieved complete remission (CR) after chemoradiotherapy and pembrolizumab.

CASE REPORT

Case 1 was diagnosed with cervical adenocarcinoma, stage IVB. She obtained CR after concurrent chemoradiotherapy (CCRT) and post-CCRT adjuvant chemotherapy and bevacizumab. Recurrence at previous irradiated sacral bone was controlled with pembrolizumab and CCRT using proton therapy (PT). Case 2 was diagnosed with stage IVB squamous cell carcinoma. First recurrence occurred at inguinal lymph node (LN). Secondary recurrence occurred at paraaortic LN ten years later. PT with chemotherapy and pembrolizumab achieved CR. Case 3 had a small cell carcinoma (stage IVB) with bone metastasis. She had CR to CCRT with etoposide-cisplatin. Liver metastasis was salvaged with CCRT and pembrolizumab.

CONCLUSION

CCRT with pembrolizumab is potentially curative for recurrent cervical cancer conventionally amenable for palliation.

摘要

目的

复发性宫颈癌在既往放疗区域出现且无法切除或远处转移时难以治疗。我们报告了 3 例此类患者，他们在接受放化疗和帕博利珠单抗治疗后达到完全缓解（CR）。

病例报告

病例 1 被诊断为宫颈腺癌，IVB 期。她在同步放化疗（CCRT）和 CCRT 后辅助化疗及贝伐珠单抗治疗后获得 CR。先前放疗骶骨部位复发，使用派姆单抗和质子治疗（PT）进行 CCRT 控制。病例 2 被诊断为 IVB 期鳞状细胞癌。首次复发发生在腹股沟淋巴结（LN）。10 年后，二次复发发生在腹主动脉旁 LN。化疗联合派姆单抗和 PT 治疗后达到 CR。病例 3 患有小细胞癌（IVB 期）伴骨转移。她对依托泊苷顺铂 CCRT 有反应，达到 CR。肝转移经 CCRT 和派姆单抗治疗得以挽救。