文章摘要

1例肺腺癌的综合治疗与全程管理经验并文献复习

作者: 1饶 冰玉, 1罗 红鹤, 1雷 艺炎
1 中山大学附属第一医院胸外科,广州 510080
通讯: 雷 艺炎 Email: leiyyzsu@126.com
DOI: 10.3978/j.issn.2095-6959.2020.02.040

摘要

肺癌是目前世界上发病率及病死率均居首位的恶性肿瘤。其中,肺腺癌是最常见的病理类型。肺腺癌的综合治疗及全程管理模式对于改善预后起至关重要的作用。现报告1例48岁男性肺腺癌患者的综合治疗及全程管理过程,并针对该患者的诊疗经验进行文献复习。该患者的临床诊断为右中肺癌,行胸腔镜右中肺癌根治术,病理诊断为腺癌。术后1年出现复发,口服吉非替尼治疗2个月后进展,改用铂类联合培美曲塞方案化学药物治疗8疗程,疾病进展,予安维汀加泰索帝联合顺铂方案化学药物治疗5疗程,因出现肾功能不全而停止。液体检测:T790M(+)。患者口服奥希替尼至2019年10月,病情稳定。非小细胞肺癌的个体化评估、综合治疗及全程化管理模式对改善非小细胞肺癌患者的预后具有重要意义。
关键词: 非小细胞肺癌;综合治疗;全程管理;预后

Combined modality therapy and management to lung adenocarcinoma: A case report and literature review

Authors: 1RAO Bingyu, 1LUO Honghe, 1LEI Yiyan
1 Department of Thoracic Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China

CorrespondingAuthor:LEI Yiyan Email: leiyyzsu@126.com

Abstract

Lung cancer is the most common malignant tumor in the world in terms of morbidity and mortality. Among them, lung adenocarcinoma is the most common pathological type. The combined modality therapy and whole-process management of lung adenocarcinoma play an important role in improving the prognosis. We summarized in this article the comprehensive treatment and the whole management process of a patient with lung adenocarcinoma, and reviewed the literatures on the diagnosis and treatment experience of this patient. A 48-year-old male was diagnosed as lung cancer of right middle lobe. He underwent radical resection of cancer via video-assisted thoracoscopic surgery (VATS). The pathological diagnosis was lung adenocarcinoma. Recurrence occurred one year after operation. Iressa was given to the patient only for two months because of the disease progression. Platinum combined with pemetrexed regimen was used for 8 courses. Disease progress was evaluated again. Avastin plus taxotere combined with cisplatin regimen was given for 5 courses but forced to stop because of renal insufficiency. Liquid test was T790M (+). Osimertinib was given to this patient who has been in stable condition from then. Individualized assessment, combined modality therapy and whole-process management of non-small cell lung cancer are important to improve the prognosis of patients with non-small cell lung cancer.
Keywords: non-small cell lung cancer; combined modality therapy; whole-process management; prognosis