1例晚期非小细胞肺癌的综合治疗
| 作者: |
1胡春秀,
1姜忠于,
1杨征奇,
1王立
1 浙江衢化医院肿瘤科，浙江 衢州 324004 |
| 通讯: |
胡春秀
Email: huchunxiu8@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.11.044 |
摘要
浙江衢化医院收治1例晚期非小细胞肺癌(non-small cell lung cancer，NSCLC)患者，女，64岁，无明显诱因出现咳嗽，咳痰3个月余。胸部CT示：两肺多发浸润性灶，纵隔多发淋巴结肿大伴环形强化。腰椎MRI示：胸12椎体、腰1左侧椎弓、腰3/4椎体异常信号，考虑转移瘤。支气管镜病理示：(右肺中间支气管)腺癌。免疫组织化学示：CK7(+)，CK14(−)，TTF-1(+)，p63(−)，CEA(−)，Ki-67(+++)45%，SPA(−)，CK5/6(−)。EGFR基因检测示：Exon21突变。患者拒绝化学药物治疗，病情反复进展，经多次放射治疗及靶向治疗后，截至2019年5月31日，患者死亡，总生存期62个月。
关键词：
晚期非小细胞肺癌；表皮细胞生长因子受体激酶抑制剂；放射治疗
Comprehensive treatment of advanced non-small cell lung cancer: A case report
CorrespondingAuthor: HU Chunxiu Email: huchunxiu8@163.com
DOI: 10.3978/j.issn.2095-6959.2019.11.044
Abstract
A 64-year-old women with advanced non-small cell lung cancer was admitted to Zhejiang Quhua Hospital, after invalid treatments in a local hospital for no obvious cause of cough and sputum for more than 3 months. Chest CT showed multiple infiltrates in both lungs, mediastinal multiple lymphadenopathy with annular enhancement. Lumbar MRI examination revealed chest 12 vertebral body, lumbar 1 left vertebral arch, lumbar 3, 4 vertebral abnormal signals, considering metastases. Bronchoscopy pathology showed (right lung middle bronchus) adenocarcinoma. Immunohistochemistry revealed CK7(+), CK14(−), TTF-1+, p63(−), CEA(−), Ki-67(+++)45%, SPA(−), CK5/6(−). EGFR gene detection showed Exon21 mutation. The patient refused chemotherapy and progressed repeatedly. After multiple radiotherapy and targeted therapy, as of May 31, 2019, the patient died, with a total survival period of 62 months.
Keywords：
advanced non-small cell lung cancer; epidermal growth factor receptor-tyrosine kinase inhibitor; radiation therapy