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本文引用的文献

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Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with metastatic colorectal cancer.泛亚地区适应的 ESMO 临床实践指南:转移性结直肠癌患者的诊断、治疗和随访。
ESMO Open. 2023 Jun;8(3):101558. doi: 10.1016/j.esmoop.2023.101558. Epub 2023 May 24.
2
Rectal Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology.《直肠癌(2022 年第 2 版)》,美国国家综合癌症网络(NCCN)肿瘤学临床实践指南。
J Natl Compr Canc Netw. 2022 Oct;20(10):1139-1167. doi: 10.6004/jnccn.2022.0051.
3
Brain metastasis from colorectal cancer: Treatment, survival, and prognosis.结直肠癌脑转移:治疗、生存和预后。
Medicine (Baltimore). 2022 Oct 7;101(40):e30273. doi: 10.1097/MD.0000000000030273.
4
Treatment for Brain Metastases: ASCO-SNO-ASTRO Guideline.脑转移瘤的治疗:美国临床肿瘤学会-神经肿瘤学会-美国放射肿瘤学会指南
J Clin Oncol. 2022 Feb 10;40(5):492-516. doi: 10.1200/JCO.21.02314. Epub 2021 Dec 21.
5
Comparison of safety and efficacy of fluorouracil + oxaliplatin + irinotecan (FOLFOXIRI) and modified FOLFOXIRI with bevacizumab for metastatic colorectal cancer: data from clinical practice.氟尿嘧啶+奥沙利铂+伊立替康(FOLFOXIRI)与贝伐珠单抗联合改良 FOLFOXIRI 治疗转移性结直肠癌的安全性和疗效比较:来自临床实践的数据。
Int J Colorectal Dis. 2022 Feb;37(2):337-348. doi: 10.1007/s00384-021-04064-9. Epub 2021 Nov 12.
6
Cetuximab Can Be an Effective and Low-Toxicity Maintenance Treatment Drug in Patients With Metastatic Colorectal Cancer: A Real-World Study of Zhejiang Cancer Hospital.西妥昔单抗可作为转移性结直肠癌患者有效且低毒的维持治疗药物:浙江大学医学院附属肿瘤医院的一项真实世界研究
Front Pharmacol. 2021 May 28;12:632076. doi: 10.3389/fphar.2021.632076. eCollection 2021.
7
Brain Metastases from Colorectal Cancer: A Systematic Review of the Literature and Meta-Analysis to Establish a Guideline for Daily Treatment.结直肠癌脑转移:文献系统评价与Meta分析以制定日常治疗指南
Cancers (Basel). 2021 Feb 21;13(4):900. doi: 10.3390/cancers13040900.
8
FOLFIRI plus cetuximab or bevacizumab for advanced colorectal cancer: final survival and per-protocol analysis of FIRE-3, a randomised clinical trial.FOLFIRI 联合西妥昔单抗或贝伐珠单抗治疗晚期结直肠癌:FIRE-3 随机临床试验的最终生存和方案分析。
Br J Cancer. 2021 Feb;124(3):587-594. doi: 10.1038/s41416-020-01140-9. Epub 2020 Nov 6.
9
Incidence of Asymptomatic Brain Metastases in Metastatic Colorectal Cancer.无症状脑转移在转移性结直肠癌中的发生率。
Clin Colorectal Cancer. 2020 Dec;19(4):263-269. doi: 10.1016/j.clcc.2020.09.002. Epub 2020 Sep 12.
10
Bevacizumab-based treatment as salvage therapy in patients with recurrent symptomatic brain metastases.以贝伐单抗为基础的治疗作为复发性有症状脑转移患者的挽救疗法。
Neurooncol Adv. 2020 Mar 16;2(1):vdaa038. doi: 10.1093/noajnl/vdaa038. eCollection 2020 Jan-Dec.

采用全脑放疗联合贝伐单抗及化疗治疗直肠癌脑转移:1例报告

Management of brain metastasis from rectal cancer using whole‑brain radiation therapy followed by bevacizumab and chemotherapy: A case report.

作者信息

Van Nguyen Hung, Phung Duong Thuy, Nguyen Trung Thanh, Tran Bach Trung, Thi Mai Kim Ngan, Le Trinh Huy

机构信息

Department of Oncology and Palliative Care, Hanoi Medical University Hospital, Hanoi 100000, Vietnam.

Department of Oncology, Hanoi Medical University, Hanoi 100000, Vietnam.

出版信息

Oncol Lett. 2023 Aug 30;26(4):446. doi: 10.3892/ol.2023.14033. eCollection 2023 Oct.

DOI:10.3892/ol.2023.14033
PMID:37720667
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10502923/
Abstract

Brain metastases in colorectal cancer are uncommon, which has resulted in a shortage of data concerning their screening and management. Multiple therapeutic modalities with chemotherapy, chemoradiation and targeted therapy, including bevacizumab and cetuximab regimens, have shown promising results. The present study describes the case of a 47-year-old male, diagnosed with T4N2M1 rectal cancer who underwent systemic therapy with modified FOLFOXIRI and cetuximab. The patient achieved a complete clinical response after 12 cycles. Following the discontinuation of cetuximab, the patient was given capecitabine as a maintenance therapy and subsequently developed brain metastasis. The patient received whole-brain radiation therapy (WBRT) followed by a bevacizumab plus FOLFIRI regimen. The patient showed a good response as revealed by cranial magnetic resonance imaging, with a reduction in lesion size and no sign of cerebral edema. In addition, the patient maintained a stable neurological condition for >10 months. These findings suggest that the early detection of brain metastases requires the close monitoring of neurological symptoms. In addition, WBRT followed by bevacizumab and chemotherapy is a potential management plan for brain metastasis from rectal cancer.

摘要

结直肠癌脑转移并不常见,这导致了有关其筛查和管理的数据短缺。多种治疗方式,包括化疗、放化疗和靶向治疗(如贝伐单抗和西妥昔单抗方案),已显示出有前景的结果。本研究描述了一名47岁男性的病例,该患者被诊断为T4N2M1期直肠癌,接受了改良FOLFOXIRI和西妥昔单抗的全身治疗。患者在12个周期后实现了完全临床缓解。停用西妥昔单抗后,患者接受卡培他滨作为维持治疗,随后发生了脑转移。患者接受了全脑放射治疗(WBRT),随后采用贝伐单抗加FOLFIRI方案。头颅磁共振成像显示患者反应良好,病灶大小减小,且无脑水肿迹象。此外,患者的神经状况在超过10个月的时间里保持稳定。这些发现表明,脑转移的早期检测需要密切监测神经症状。此外,WBRT后联合贝伐单抗和化疗是直肠癌脑转移的一种潜在管理方案。