Oncology Department, The Second Neijiang People's Hospital, Neijiang, Sichaun, P.R. China.
Department of Gastroenterology, Nan-Chang Hospital, Sun Yat-Sen University, Nanchang, Jiangxi, P.R. China.
J Int Med Res. 2021 Nov;49(11):3000605211055387. doi: 10.1177/03000605211055387.
Pulmonary large cell neuroendocrine carcinoma (LCNEC), which accounts for approximately 1% of all lung cancers, is a rare and highly aggressive malignancy with a poor prognosis. Therefore, it is important to devise an effective treatment strategy. In the treatment of locally advanced complex LCNEC, it is unique to first administer radiotherapy combined with albumin-bound paclitaxel plus carboplatin, followed by durvalumab for immune maintenance treatment after concurrent radiotherapy and chemotherapy to achieve complete remission. We report a 54-year-old man who smoked and who felt chest tightness for 2 weeks and was diagnosed as having combined pulmonary LCNEC. For patients with locally advanced pulmonary LCNEC, chemoradiotherapy increases overall survival. After surgical resection and chemoradiotherapy, our patient achieved complete remission. Durvalumab was then started to consolidate the treatment. After six courses of immune maintenance therapy, the patient developed grade 2 immune-related pneumonitis and took prednisone orally until the symptoms resolved, and then reached complete remission again. The patient achieved complete remission, which was a challenge with this rare carcinoma, through albumin-bound paclitaxel plus platinum-based chemotherapy combined with radiotherapy and durvalumab for immune maintenance therapy. This approach may provide a treatment option for locally advanced combined pulmonary LCNEC.
肺大细胞神经内分泌癌（LCNEC）约占所有肺癌的 1%，是一种罕见且高度侵袭性的恶性肿瘤，预后较差。因此，制定有效的治疗策略非常重要。在局部晚期复杂 LCNEC 的治疗中，首先给予放疗联合白蛋白结合紫杉醇加卡铂，然后在同步放化疗后使用度伐利尤单抗进行免疫维持治疗，以实现完全缓解，这是独特的。我们报告了一名 54 岁男性，有吸烟史，胸闷 2 周，被诊断为合并性肺 LCNEC。对于局部晚期肺 LCNEC 患者，放化疗可提高总生存率。在手术切除和放化疗后，我们的患者达到完全缓解。然后开始使用度伐利尤单抗进行巩固治疗。在进行了六轮免疫维持治疗后，患者出现 2 级免疫相关性肺炎，并口服泼尼松，直到症状缓解，然后再次达到完全缓解。该患者通过白蛋白结合紫杉醇加铂类化疗联合放疗和度伐利尤单抗进行免疫维持治疗，达到完全缓解，这对这种罕见的癌是一个挑战。这种方法可能为局部晚期合并性肺 LCNEC 提供一种治疗选择。
