As soon as I heard that the cancer was terminal
People think of it for the first time
Incurable and incurable
As a result, there is no hope for life
Recently, the oncology team of Jiangxi Chest Hospital (the Third Affiliated Hospital of Nanchang Medical College) used individualized immunotherapy to win the life of a refractory lung cancer patient.
Xia, a 51-year-old patient, was admitted to a local hospital for chest tightness and shortness of breath, suspected of malignant pleural effusion, and his condition did not improve after 1 week of treatment, but became more serious. Tang Xiaomei, chief physician and deputy director of the Department of Oncology, received the patient, carefully inquired about the patient's condition, checked various examination reports, and found that the patient's pleural effusion grew rapidly, with a large amount of bloody pleural effusion, accompanied by complications such as hypoproteinemia, severe anemia, and severe infection, and his condition was very critical.
Diagram of the patient's bloody pleural effusion
Tang Xiaomei immediately arranged for the patient to undergo internal medicine thoracoscopy, and combined with the pathological results, the patient was diagnosed with lung adenocarcinoma, and at the same time, it was also combined with malignant pleural effusion, and the pleura metastasized, and the opportunity for surgery was lost. If not treated aggressively, patients will survive no more than 2 months. According to the results of the patient's genetic testing, the use of immunotherapy will have a good effect on the tumor.
Tang Xiaomei's ward rounds
According to the patient's condition, the oncology team of the hospital conducted a difficult case discussion, comprehensively considered the patient's physical constitution and economic status, and formulated an individualized treatment plan for the patient—first control the growth of pleural fluid with Endo pleural perfusion, followed by bevacizumab antivascular therapy + sintilimab immunotherapy every 21 days to control pleural effusion and tumor.
CT image of the patient's chest (at the time of admission)
Patient's chest CT (at discharge)
After two cycles of immunotherapy, the patient's condition improved significantly, and the re-examination of CT showed that the absorption of lung lesions was significantly reduced, the symptoms of chest tightness and shortness of breath were gradually reduced, and he was able to walk on his own, and his quality of life was greatly improved, and he was successfully discharged from the hospital.
The patient's condition gradually improved and he was able to walk on his own
Tang Xiaomei, chief physician and deputy director of the Department of Oncology, said that advanced lung cancer combined with refractory carcinous pleural effusion is a common complication of advanced lung cancer, and its condition is dangerous, easy to recur, and even life-threatening. At present, the diagnosis and treatment plan of lung cancer is iteratively updated rapidly, and various treatment methods are emerging in an endless stream, so it is extremely important to formulate an individualized treatment plan for patients. Compared with traditional chemotherapy and targeted therapy, immunotherapy has many advantages such as less side effects, light economic burden, and significant efficacy, especially for patients with high immune expression, which can achieve better efficacy, providing a new treatment option for some lung cancer populations.
Immunotherapy is the use of activating the body's immune system to attack cancer cells, mainly including PD-1 and PD-L1 inhibitors, CTLA-4 inhibitors, etc. PD-1 and PD-L1 inhibitors are representatives of immune checkpoint inhibitors, which activate the body's immune system by blocking the action of immune checkpoints, so that T cells can attack tumor cells and achieve the purpose of controlling tumor shrinkage.
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Author of this article
Author: Hu Qifeng, attending physician of the First Department of Oncology, Jiangxi Chest Hospital
Correspondents: Huang Xuan, Lu Yizhou, Zhang Jiyun
Editor: Huang Menglin
Reviewer: Chen Shirui
Issued: Daley Red
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