Wang Tingting, Wang Rong, Liu Lianke
Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Transl Cancer Res. 2020 Apr;9(4):3003-3006. doi: 10.21037/tcr.2020.03.13.
For upper thoracic esophageal cancer, surgery is difficult, and the clinical effects of chemoradiotherapy, radiotherapy, and chemotherapy are limited. Camrelizumab is a PD-1 (programmed cell death-1) antibody developed by China. There are few studies on camrelizumab in esophageal cancer. Here, a 66-year-old man was admitted to the hospital with severe dysphagia. He was diagnosed as upper thoracic esophageal squamous cell carcinoma (ESCC). The patient received nasogastric tube placement, chemotherapy with docetaxel and nedaplatin, monotherapy with camrelizumab, combination therapy with camrelizumab and docetaxel, maintenance therapy with docetaxel, successively. One year later, complete response was observed and the nasogastric tube was removed. The progression-free survival (PFS) exceeded 28 months. The patient is still being followed up. In this paper, temporary nasogastric tube feeding not only provided nutrients safely, but also won the time for immunotherapy to work. Camrelizumab-containing therapy achieved complete response with long-term survival in unresectable upper thoracic ESCC patients. Comprehensive therapy regimens involved with nasogastric tube feeding and camrelizumab-containing therapy are effective and safe in unresectable upper thoracic ESCC patients with severe dysphagia.
对于胸段上段食管癌，手术难度大，放化疗和单纯化疗的临床效果有限。卡瑞利珠单抗是中国研发的一种程序性死亡受体1（PD-1）抗体。目前关于卡瑞利珠单抗治疗食管癌的研究较少。在此，一名66岁男性因严重吞咽困难入院。他被诊断为胸段上段食管鳞状细胞癌（ESCC）。该患者先后接受了鼻胃管置入、多西他赛和顺铂化疗、卡瑞利珠单抗单药治疗、卡瑞利珠单抗与多西他赛联合治疗、多西他赛维持治疗。1年后，观察到完全缓解，鼻胃管拔除。无进展生存期（PFS）超过28个月。该患者仍在随访中。本文中，临时鼻胃管喂养不仅安全地提供了营养，还为免疫治疗发挥作用赢得了时间。含卡瑞利珠单抗的治疗方案在不可切除的胸段上段ESCC患者中实现了完全缓解并长期生存。对于有严重吞咽困难的不可切除胸段上段ESCC患者，涉及鼻胃管喂养和含卡瑞利珠单抗治疗的综合治疗方案有效且安全。
