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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.

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。

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