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免疫疗法联合放疗治疗无BRAF突变的恶性黑色素瘤脑转移——免疫疗法在病情进展后继续使用出现良好反应。

Immunotherapy Combined with Radiation in Malignant Melanoma without BRAF Mutations Brain Metastases-Favorable Response after Immunotherapy Continued beyond Progression.

作者信息

Rahnea-Nita Roxana-Andreea, Rebegea Laura-Florentina, Toma Radu-Valeriu, Mocanu Horia, Soare Ioana, Mihailov Raul, Nechifor Alexandru, Guliciuc Mădălin, Constantin Georgiana Bianca, Rahnea-Nita Gabriela

机构信息

The Clinical Department, The Faculty of Medicine, The University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania.

The Oncology-Palliative Care Department, "Sf. Luca" Chronic Disease Hospital, 041915 Bucharest, Romania.

出版信息

J Pers Med. 2024 Jan 12;14(1):86. doi: 10.3390/jpm14010086.

Abstract

We present the case of a patient who was diagnosed in 2018 with nodular Malignant Melanoma (MM) without BRAF V 600 mutations stage 3 C (pT4b pN1a M0), and who underwent adjuvant citokines treatment with Interferon alpha 2b-48 weeks. Immunotherapy was initiated in January 2021 for lung and lymph node metastases. In June 2021, there was a partial response of the lung and lymph node metastases, but there was also progression to brain metastases. Immunotherapy was continued and Whole Brain Radiotherapy (WBRT) was performed. In September 2023, the imaging investigations revealed a favorable response, with no lesions suggestive of secondary determinations. The combination of Radiotherapy (RT) and Immunotherapy (IT) with Immune Checkpoint Inhibitors (ICI) has an abscopal effect. There is a coordinated action in the combination of RT and IT in order to obtain a common result, with the antitumor effect being greater than if RT or IT acted separately.

摘要

我们报告了一例患者,该患者于2018年被诊断为无BRAF V 600突变的结节性恶性黑色素瘤(MM),分期为3 C期(pT4b pN1a M0),并接受了为期48周的α-2b干扰素辅助细胞因子治疗。2021年1月开始针对肺和淋巴结转移进行免疫治疗。2021年6月,肺和淋巴结转移出现部分缓解,但也出现了脑转移进展。继续进行免疫治疗并实施了全脑放疗(WBRT)。2023年9月,影像学检查显示有良好反应,未发现提示二次病变的迹象。放疗(RT)与免疫治疗(IT)联合免疫检查点抑制剂(ICI)具有远隔效应。RT和IT联合使用时有协同作用以获得共同结果,其抗肿瘤效果大于RT或IT单独作用时的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9073/10817469/9fa216019cf0/jpm-14-00086-g001.jpg

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