Xiang Yongbo, Tang Wei, Wang Jianyang, Wang Zhijie, Bi Nan
Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Center for National Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Oncol. 2023 Jul 28;13:1021253. doi: 10.3389/fonc.2023.1021253. eCollection 2023.
Pseudoprogression is rarely mentioned after radiotherapy except for central nervous system tumors. With the widespread of immunotherapy, the incidence of pseudoprogression of thoracic tumor after radiotherapy is increasing. This study summarized the clinical features of pseudoprogression in 4 patients who had underwent thoracic radiotherapy after and/or followed by immunotherapy. All of them had received chemotherapy and immunotherapy before thoracic radiotherapy. After radiotherapy, pseudoprogression occurred within 3 months after initiation of immune consolidation/rechallenge therapy. At least a 20% increase in the sum of the longest diameter of target lesions were measured on their chest image. During this period, patients' ECOG PS scores remained stable, specific serum tumor markers did not increase significantly. Treatment strategies did not change after pseudoprogression. The causes of radiographic pseudoprogression in this case series may be attributed to disturbances such as pneumonitis, atelectasis, mucus blockages and infection. In the era of immunotherapy, pseudoprogression of thoracic tumors after chest radiotherapy might become a common phenomenon. It is important for us to identify pseudoprogression based on patient's general status, radiological changes, and laboratory tests.
除中枢神经系统肿瘤外，放疗后很少提及假性进展。随着免疫疗法的广泛应用，放疗后胸段肿瘤假性进展的发生率正在增加。本研究总结了4例接受胸段放疗后和/或放疗后接受免疫治疗的患者假性进展的临床特征。他们均在胸段放疗前接受过化疗和免疫治疗。放疗后，在免疫巩固/再激发治疗开始后3个月内出现假性进展。胸部影像显示靶病灶最长径总和至少增加20%。在此期间，患者的东部肿瘤协作组（ECOG）体力状况评分保持稳定，特异性血清肿瘤标志物未显著升高。假性进展后治疗策略未改变。本病例系列中影像学假性进展的原因可能归因于肺炎、肺不张、黏液阻塞和感染等干扰因素。在免疫治疗时代，胸段放疗后胸段肿瘤的假性进展可能会成为一种常见现象。基于患者的一般状况、影像学变化和实验室检查来识别假性进展对我们来说很重要。
