Muto Momotaro, Nakata Hirotaka, Ishigaki Kenichi, Tachibana Shion, Yoshida Moe, Muto Mizue, Yanagawa Nobuyuki, Okumura Toshikatsu
Department of Internal Medicine, Engaru Kosei General Hospital, Engaru, Japan.
Division of Metabolism, Systemic Bioscience, Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
J Gastric Cancer. 2021 Sep;21(3):319-324. doi: 10.5230/jgc.2021.21.e24. Epub 2021 Aug 24.
The abscopal effect refers to the phenomenon in which local radiotherapy is associated with the regression of metastatic cancer that is distantly located from the irradiated site. Here, we present a case of a patient with advanced gastric cancer and brain metastases who was successfully treated with brain radiotherapy and anti-programmed death-1 (PD-1) therapy-induced abscopal effect. Although anti-PD-1 therapy alone could not prevent disease progression, the metastatic lesions in the brain and also in the abdominal lymph node showed a drastic response after brain radiotherapy and anti-PD-1 therapy. To our knowledge, this is the first reported case of successful treatment of advanced gastric cancer with multiple brain and abdominal lymph node metastases, possibly through anti-PD-1 therapy combined with brain radiotherapy-induced abscopal effect. We suggest that the combination of brain radiotherapy and anti-PD-1 therapy may be considered as a therapeutic option for advanced gastric cancer, especially when there is brain metastasis.
远隔效应是指局部放疗与远离照射部位的转移性癌症消退相关的现象。在此，我们报告一例晚期胃癌伴脑转移患者，其通过脑部放疗和抗程序性死亡蛋白1（PD-1）治疗诱导的远隔效应成功得到治疗。尽管单独使用抗PD-1治疗无法阻止疾病进展，但脑部放疗和抗PD-1治疗后，脑部以及腹部淋巴结的转移病灶出现了显著反应。据我们所知，这是首例成功治疗多发脑转移和腹部淋巴结转移的晚期胃癌病例，可能是通过抗PD-1治疗联合脑部放疗诱导的远隔效应实现的。我们建议，脑部放疗和抗PD-1治疗的联合可被视为晚期胃癌尤其是伴有脑转移时的一种治疗选择。
