低剂量放疗治疗人类免疫缺陷病毒感染晚期口腔癌患者获得病理完全缓解。
Pathologic complete response following low-dose radiation for advanced oral cavity cancer in a patient with human immunodeficiency virus.
机构信息
College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Department of Otorhinolaryngology - Head and Neck Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA.
出版信息
J Otolaryngol Head Neck Surg. 2022 Oct 4;51(1):37. doi: 10.1186/s40463-022-00586-6.
BACKGROUND
Advanced squamous cell carcinoma (SCCa) of the oral cavity is often not amenable to curative-intent therapy due to tumor location, tumor size, or comorbidities.
CASE PRESENTATION
A 51-year-old male patient with human immunodeficiency virus and on highly active antiretroviral therapy (HAART) presented with a cT4aN2c SCCa of the tongue. He received a preoperative single course of Quad-Shot radiation therapy to 14 Gy in 4 fractions followed by surgical resection. Patient had no residual carcinoma on surgical pathology and no evidence of disease on subsequent clinical and radiological exams.
CONCLUSIONS
To our knowledge, this is the first case of pathologic complete response for a patient on HAART following a single cycle of the Quad-Shot regimen for advanced oral cavity SCCa. Protease inhibitors in HAART can induce spontaneous tumor regression via inhibition of proteasome function and activation of apoptosis, and thus act as a cancer therapeutic.
背景
口腔高级别鳞状细胞癌（SCCa）常因肿瘤位置、肿瘤大小或合并症而无法进行根治性治疗。
病例介绍
一名 51 岁男性患者，患有人类免疫缺陷病毒（HIV），正在接受高效抗逆转录病毒治疗（HAART），他患有舌部 cT4aN2c SCCa。他接受了术前单次四剂量放射治疗，剂量为 14Gy，共 4 次分割，然后进行手术切除。术后病理未见残余癌，随后的临床和影像学检查也未发现疾病迹象。
结论
据我们所知，这是首例接受 HAART 的患者在接受四剂量方案单次治疗后，对高级口腔 SCCa 出现病理完全缓解的病例。HAART 中的蛋白酶抑制剂可通过抑制蛋白酶体功能和激活细胞凋亡来诱导肿瘤自发消退，从而发挥抗癌治疗作用。
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