Zou Dan, Yan Ying, Li Yifan, Ma Huanhuan, Bai Yuping, Wang Xueyan, Wang Bofang, Wang Yunpeng, Ma Jingwei, Chen Hao
The Second Hospital and Clinical Medical School, Lanzhou University, Lanzhou, China.
Department of Magnetic Resonance Imaging, The Second Hospital and Clinical Medical School, Lanzhou University, Lanzhou, China.
Front Immunol. 2025 Apr 1;16:1580616. doi: 10.3389/fimmu.2025.1580616. eCollection 2025.
Synchronous multiple primary esophageal cancer (SMPEC) is a rare and aggressive condition often accompanied by obstructive dysphagia, significantly impacting patients' quality of life. Current treatments, including chemotherapy, radiotherapy, immunotherapy, and targeted therapy, are limited in providing immediate symptom relief. This case report describes a 64-year-old female with SMPEC and metastases to thoracic lymph nodes, the lesser curvature of the stomach, and the right adrenal gland, presenting with severe dysphagia (score 4 on the Japanese Dysphagia Severity Scale). To rapidly alleviate symptoms, she underwent simultaneous metal stent implantation and photodynamic therapy (PDT). She started a liquid diet on the second day after treatment and resumed a normal diet one week later. Subsequently, she underwent systemic chemotherapy, targeted therapy, and immunotherapy. By the third treatment cycle, primary and metastatic lesions significantly decreased, achieving a partial response (PR) with stable disease and progression-free survival (PFS) exceeded 12 months. This triple therapy approach-combining stent implantation, PDT, and systemic treatments-proved effective and safe for advanced SMPEC, not only providing immediate dysphagia relief and selective tumor destruction but also delaying disease progression and improving patient outcomes.
同步性多原发性食管癌（SMPEC）是一种罕见且侵袭性强的疾病，常伴有梗阻性吞咽困难，严重影响患者的生活质量。目前的治疗方法，包括化疗、放疗、免疫治疗和靶向治疗，在提供即时症状缓解方面存在局限性。本病例报告描述了一名64岁女性，患有SMPEC且伴有胸段淋巴结、胃小弯和右肾上腺转移，表现为严重吞咽困难（日本吞咽困难严重程度量表评分为4分）。为迅速缓解症状，她接受了同步金属支架植入和光动力疗法（PDT）。治疗后第二天她开始进流食，一周后恢复正常饮食。随后，她接受了全身化疗、靶向治疗和免疫治疗。到第三个治疗周期时，原发灶和转移灶明显缩小，达到部分缓解（PR），病情稳定，无进展生存期（PFS）超过12个月。这种将支架植入、PDT和全身治疗相结合的三联疗法被证明对晚期SMPEC有效且安全，不仅能立即缓解吞咽困难并选择性地破坏肿瘤，还能延缓疾病进展并改善患者预后。
