Zang Rui, Zheng Linpeng, Xie Lijiao, Zhong Liangzhi, Sun Jianguo
Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing, 400037, China.
Heliyon. 2024 Oct 18;10(21):e39266. doi: 10.1016/j.heliyon.2024.e39266. eCollection 2024 Nov 15.
Primary Gastric Squamous Cell Carcinoma (GSCC), especially in late-stage, is a very rare pathological type with poor prognosis. We report a long duration of Complete Response (CR) of GSCC case with multiple metastases by an elaborate three-staged radical Concurrent Chemoradiotherapy (CCRT).
A 36-year-old male suffered from weakness and melena, and then was diagnosed as primary GSCC with cT3N3M1, Stage IV. According to the characteristics of multiple lymph nodes metastases at supraclavicular, perigastric and pelvic regions, an individualized therapeutic strategy of three-staged radical CCRT was elaborately designed and cautiously performed even after the accidental massive hemorrhage of the upper digestive tract under the guidance of a multidisciplinary team. A long-term CR was achieved, with Progression Free Survival (PFS) and Overall Survival (OS) of 74 months by the last follow-up. The case with multiple metastases was radically treated as local advanced disease with complete success.
Patient with stage IV mGSCC who has achieved CR and unexpected long-term PFS and OS through CCRT due to precise judgement and well-designed individualized therapy. The immunomodulatory effect of radiation therapy on the tumor microenvironment may be a potential mechanism affecting treatment efficacy.
原发性胃鳞状细胞癌（GSCC），尤其是晚期，是一种非常罕见的病理类型，预后较差。我们报告了一例通过精心设计的三阶段根治性同步放化疗（CCRT）实现长期完全缓解（CR）的GSCC多发转移病例。
一名36岁男性出现乏力和黑便，随后被诊断为原发性GSCC，cT3N3M1，IV期。根据锁骨上、胃周和盆腔区域多发淋巴结转移的特点，精心设计并谨慎实施了三阶段根治性CCRT个体化治疗策略，即使在多学科团队指导下上消化道意外大出血后仍继续进行。实现了长期CR，末次随访时无进展生存期（PFS）和总生存期（OS）均为74个月。该多发转移病例作为局部晚期疾病得到了根治性治疗并取得圆满成功。
IV期mGSCC患者通过精确判断和精心设计的个体化治疗，经CCRT实现了CR以及意外的长期PFS和OS。放射治疗对肿瘤微环境的免疫调节作用可能是影响治疗效果的潜在机制。
