Department of Radiotherapy, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China.
The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266003, China.
J Cancer Res Clin Oncol. 2023 Nov;149(17):16069-16073. doi: 10.1007/s00432-023-05386-7. Epub 2023 Sep 11.
Gastric metastasis of lung cancer is rare, and the cases of disappearance of gastric metastasis and liver metastasis caused by oxitinib treatment have not been reported.
A 47-year-old male patient with no history of diabetes, hypertension or smoking presented with chest discomfort after eating. At the time of consultation, the diagnosis of adenocarcinoma of the right lower lobe of the lung with liver and gastric metastasis was considered by pathological examination of biopsy of the fundus of the stomach near the cardia, pathological examination of CT-guided lung aspiration and pathological examination of liver occupancy aspiration, combined with immunohistochemical results. He was found to have exon 19 deletion in next generation sequencing. We performed osimertinib on him (EGFR-TKI) systemic therapy, followed by local radiation therapy to the right lower lung primary lesion.
After systemic treatment with osimertinib and local radiotherapy of the primary site, the metastases disappeared and the primary site showed post-radiotherapy changes, and the evaluated efficacy was complete remission.
This is the first report to our knowledge of a patient who presented with gastric and hepatic metastases from lung cancer and achieved complete remission with osimertinib and local radiotherapy, with good quality of life, which also provides a basis for future clinical work and is of great significance.
肺癌胃转移较为罕见，且奥希替尼治疗导致胃转移和肝转移消失的病例尚未见报道。
一名 47 岁男性患者，无糖尿病、高血压或吸烟史，进食后出现胸痛。就诊时，根据贲门附近胃底活检的病理检查、CT 引导下肺抽吸的病理检查和肝占位抽吸的病理检查，结合免疫组化结果，考虑诊断为右肺下叶腺癌伴肝、胃转移。他在下一代测序中发现存在外显子 19 缺失。我们对他进行了奥希替尼（EGFR-TKI）全身治疗，随后对右下肺原发灶进行局部放射治疗。
奥希替尼全身治疗和原发灶局部放疗后，转移灶消失，原发灶显示放疗后改变，疗效评估为完全缓解。
据我们所知，这是首例报道的肺癌伴胃和肝转移患者，奥希替尼联合局部放疗达到完全缓解，生活质量良好，这也为未来的临床工作提供了依据，具有重要意义。
