Costa Mafalda, Magalhães Helena
Department of Medical Oncology, Hospital Pedro Hispano, Matosinhos, Portugal.
Oncoscience. 2024 Oct 8;11:92-98. doi: 10.18632/oncoscience.609. eCollection 2024.
Approximately 20% of lung cancer patients have brain metastasis at diagnosis, which is associated with a worse prognosis and a negative impact on quality of life. The emergence of new systemic treatment options such as immune checkpoint inhibitors (ICI) and targeted therapies changed the prognosis for stage IV lung cancer patients. However, the impact of local and systemic treatment sequencing in patients with stage IV lung cancer and brain metastasis is still unclear. We present the case of a 51-year-old man with stage IV non-small cell lung cancer and brain metastasis at diagnosis who underwent whole brain radiotherapy (WBRT) and achieved intracranial and extracranial complete response after second-line treatment with an ICI. Currently, the patient has an overall survival of 87 months and a progression-free survival of 73 months with an optimal quality of life. We hypothesized that treatment sequencing of WBRT and immunotherapy could explain this unexpected outcome.
约20%的肺癌患者在确诊时已有脑转移，这与较差的预后及生活质量的负面影响相关。免疫检查点抑制剂（ICI）和靶向治疗等新的全身治疗方案的出现改变了IV期肺癌患者的预后。然而，IV期肺癌合并脑转移患者的局部和全身治疗顺序的影响仍不明确。我们报告一例51岁男性患者，诊断为IV期非小细胞肺癌并伴有脑转移，接受了全脑放疗（WBRT），并在接受ICI二线治疗后实现了颅内和颅外完全缓解。目前，该患者总生存期为87个月，无进展生存期为73个月，生活质量良好。我们推测WBRT和免疫治疗的治疗顺序可以解释这一意外结果。
