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新辅助化疗联合特瑞普利单抗治疗局部晚期非小细胞肺癌后行电视辅助胸腔镜手术肺叶切除术的初步经验:1 例报告。

Initial experience of video-assisted thoracic surgery lobectomy after neoadjuvant chemotherapy plus toripalimab in a patient with locally advanced non-small cell lung cancer: a case report.

机构信息

Department of Second Ward of Thoracic Surgery, The First Affiliated Hospital, Weifang Medical University (Weifang People's Hospital), 151 Guangwen Street, Weifang, 261041, China.

出版信息

J Cardiothorac Surg. 2022 Jan 16;17(1):10. doi: 10.1186/s13019-021-01741-2.

Abstract

BACKGROUND

Immune checkpoint inhibitors were used for patients with advanced non-small cell lung cancer (NSCLC) more and more frequently and the effects were thrilling. Toripalimab as a new immune checkpoint inhibitor has been shown to be effective in patients with advanced NSCLC. However, data regarding the safety and feasibility of surgical resection after treatment with toripalimab for NSCLC remain scarce. Here, we present a case with locally advanced NSCLC that received video-assisted thoracic surgery (VATS) lobectomy after treatment with toripalimab in combination with chemotherapy.

CASE PRESENTATION

A 62-year-old male patient with a history of coronary artery stenting operation for two times was found a 3.4 × 3.2 cm cavity mass in the upper lobe of the left lung and enlarged left hilar and mediastinal lymph nodes. Pathological results identified squamous cell carcinoma. The patient was diagnosed with a locally advanced NSCLC and received VATS left upper lobectomy and lymph node dissection after neoadjuvant chemotherapy plus toripalimab for 3 cycles. The postoperative pathological results showed complete tumor remission. Short-term follow-up results were excellent, and long-term results remain to be revealed.

CONCLUSIONS

Our preliminary results showed that the use of neoadjuvant toripalimab and chemotherapy for the locally advanced NSCLC before surgical resection is safe and feasible.

摘要

背景

免疫检查点抑制剂越来越多地用于治疗晚期非小细胞肺癌(NSCLC)患者,疗效令人振奋。作为一种新型免疫检查点抑制剂,特瑞普利单抗已被证明对晚期 NSCLC 患者有效。然而,关于 NSCLC 患者接受特瑞普利单抗治疗后行手术切除的安全性和可行性的数据仍然有限。在这里,我们报告了 1 例局部晚期 NSCLC 患者,在接受特瑞普利单抗联合化疗治疗后行电视辅助胸腔镜手术(VATS)肺叶切除术。

病例介绍

一名 62 岁男性患者,有两次冠状动脉支架植入术史,在左肺上叶发现 3.4×3.2cm 的空洞性肿块,伴左肺门和纵隔淋巴结肿大。病理结果提示为鳞状细胞癌。该患者被诊断为局部晚期 NSCLC,在接受 3 个周期新辅助化疗加特瑞普利单抗治疗后,行 VATS 左肺上叶切除术和淋巴结清扫术。术后病理结果显示完全肿瘤消退。短期随访结果良好,长期结果仍有待揭示。

结论

我们的初步结果表明,在手术切除前使用新辅助特瑞普利单抗和化疗治疗局部晚期 NSCLC 是安全可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9208/8762932/db7d862ae297/13019_2021_1741_Fig1_HTML.jpg

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