Nagasaka Hirotaka, Takebe Shinichi, Yamamoto Shotaro, Kondo Takuya, Terao Hideyuki, Nakaigawa Noboru, Kishida Takeshi
Department of Urology, Kanagawa Cancer Center, Yokohama, Japan.
Case Rep Oncol. 2023 Sep 25;16(1):1028-1032. doi: 10.1159/000533888. eCollection 2023 Jan-Dec.
A 35-year-old man was diagnosed with stage IIIC non-seminoma with paralysis of the lower half of his body due to 8th thoracic spine metastasis. The patient received bleomycin, etoposide, and cisplatin (BEP) therapy. On day 4 of the second course of BEP, the patient developed a fever and was diagnosed with coronavirus disease (COVID-19). COVID-19 was suspected to worsen because of cancer and chemotherapy-induced immunosuppression. However, the benefits of continuing BEP therapy outweighed these risks. After obtaining fully informed consent, BEP therapy was continued from day 5, while sotrovimab (anti-COVID-19 drug) was administered. The second course of BEP was completed without worsening severe COVID-19 or bleomycin-induced lung injury. The patient completed four courses of BEP, with normalization of tumor markers, partial response on imaging, and improvement in lower body paralysis. In this case, we successfully treated a patient with testicular germ cell tumor with chemotherapy while having COVID-19 without treatment delay. During the COVID-19 pandemic, concomitant chemotherapy and COVID-19 treatment are warranted because delaying treatment will decrease the efficacy of highly curative diseases such as germ cell tumors.
一名35岁男性被诊断为IIIC期非精原细胞瘤,因第8胸椎转移导致下半身瘫痪。患者接受了博来霉素、依托泊苷和顺铂(BEP)治疗。在BEP第二个疗程的第4天,患者出现发热,被诊断为冠状病毒病(COVID-19)。由于癌症和化疗引起的免疫抑制,怀疑COVID-19病情恶化。然而,继续BEP治疗的益处超过了这些风险。在获得充分知情同意后,从第5天起继续BEP治疗,同时给予索托维单抗(抗COVID-19药物)。BEP第二个疗程顺利完成,未出现严重COVID-19恶化或博来霉素诱导的肺损伤。患者完成了四个疗程的BEP治疗,肿瘤标志物恢复正常,影像学检查有部分缓解,下半身瘫痪有所改善。在本病例中,我们成功地在患者患有COVID-19的情况下,未延迟治疗,用化疗治疗了一名睾丸生殖细胞肿瘤患者。在COVID-19大流行期间,化疗和COVID-19治疗同时进行是必要的,因为延迟治疗会降低生殖细胞肿瘤等高治愈率疾病的疗效。