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一名晚期肺鳞状细胞癌患者在接受程序性细胞死亡蛋白1抑制剂与一线化疗联合治疗时发生肿瘤溶解综合征:病例报告

Tumor lysis syndrome in a patient with advanced lung squamous cell carcinoma undergoing combined therapy with a programmed cell death protein 1 inhibitor and first‑line chemotherapy: A case report.

作者信息

Cao Li, Zhang Wei

机构信息

Department of Oncology, The Second People's Hospital of Guiyang, Guiyang, Guizhou 550081, P.R. China.

Department of Oncology, Guizhou Hospital of the First Affiliated Hospital of Sun Yat-sen University, Guiyang, Guizhou 550003, P.R. China.

出版信息

Oncol Lett. 2024 Jun 17;28(2):380. doi: 10.3892/ol.2024.14513. eCollection 2024 Aug.

DOI:10.3892/ol.2024.14513
PMID:38939620
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11209870/
Abstract

Tumor lysis syndrome (TLS) is a rare but serious complication in patients with solid tumors. It is characterized by a complex array of metabolic disturbances and clinical symptoms, resulting from the release of cellular contents into the bloodstream after tumor cell lysis. The present study reports the case of a patient with advanced lung squamous cell carcinoma (SCC) who developed TLS following combined treatment with PD-1 inhibitors and first-line chemotherapy. The treatment strategy included intravenous fluid replacement, urine alkalinization, uric acid reduction, renal protection and electrolyte stabilization, leading to the normalization of laboratory values. After one cycle of the combined therapy, the patient achieved a partial response, classified using the Response Evaluation Criteria in Solid Tumours 1.1 criteria. To the best of our knowledge, this is the first reported case of TLS in a patient with advanced lung SCC receiving concurrent PD-1 inhibitor and chemotherapy treatment. Given the increasing use of PD-1 inhibitors, it is essential to remain vigilant about the potential for TLS in solid tumors. Prompt intervention in high-risk patients, ongoing monitoring after treatment, and early detection of TLS are vital to improve patient adherence, ensure continuity of care and enhance outcomes.

摘要

肿瘤溶解综合征(TLS)是实体瘤患者中一种罕见但严重的并发症。其特征是肿瘤细胞溶解后细胞内容物释放到血液中,引发一系列复杂的代谢紊乱和临床症状。本研究报告了一例晚期肺鳞状细胞癌(SCC)患者,在接受PD-1抑制剂与一线化疗联合治疗后发生TLS的病例。治疗策略包括静脉补液、尿液碱化、降低尿酸、肾脏保护和电解质稳定,使实验室检查值恢复正常。联合治疗一个周期后,患者达到部分缓解,按照实体瘤疗效评价标准1.1进行分类。据我们所知,这是首例接受PD-1抑制剂与化疗联合治疗的晚期肺SCC患者发生TLS的报告病例。鉴于PD-1抑制剂的使用日益增加,对实体瘤患者发生TLS的可能性保持警惕至关重要。对高危患者进行及时干预、治疗后持续监测以及早期发现TLS对于提高患者依从性、确保治疗连续性和改善治疗效果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/992c/11209870/626b99ad6b08/ol-28-02-14513-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/992c/11209870/10e9b8a7742c/ol-28-02-14513-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/992c/11209870/c076be36210f/ol-28-02-14513-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/992c/11209870/a3353df08c00/ol-28-02-14513-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/992c/11209870/626b99ad6b08/ol-28-02-14513-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/992c/11209870/10e9b8a7742c/ol-28-02-14513-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/992c/11209870/c076be36210f/ol-28-02-14513-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/992c/11209870/a3353df08c00/ol-28-02-14513-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/992c/11209870/626b99ad6b08/ol-28-02-14513-g03.jpg

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