摘要
本文介绍1例表皮生长因子受体(epidermal growth factor receptor,EGFR)突变晚期非小细胞肺癌(nonsmall-cell lung cancer,NSCLC)接受表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinase inhibitors,EGFR-TKIs)治疗后,肿瘤疗效不一致,后经过多次多学科讨论,接受综合诊治的经过。该患者通过经皮肺穿刺明确Ⅳ期左肺腺癌伴纵隔肺门淋巴结、双肺及脑转移,基因检测示EGFR 19外显子缺失,一线予以EGFR-TKIs治疗。疗效考核提示左肺病灶持续有效,但右肺病灶进行性增大。右肺病灶再次活检提示鳞癌,后经化疗及右肺病灶局部放疗,双侧病灶均得到控制。患者经过多次多学科讨论,实现个体化诊疗,为患者带来生存获益。
We report a patient with advanced non-small-cell lung cancer（ NSCLC） and epidermal growth factor receptor（ EGFR） mutation,who showed different responses to EGFR-tyrosine kinase inhibitors（ TKIs） and subsequently benefited from multidisciplinary team（ MDT） management. The patient was diagnosed with stage Ⅳ adenocarcinoma of the left lung by CT guided lung puncture,with metastasis in the lung hilus,mediastina,bilateral lung and brain. Genetic screening detected a deletion in exon 19 of EGFR. The patient received EGFR-TKIs as the first line therapy. After treatment,the left lung lesion showed persistent response,but the lesion in the right lung was progressively enlarged. A second biopsy from the right lung lesion revealed squamous cell carcinoma. The patient then received chemotherapy and regional radiation for the lesion in the right lung. All of the lesions were well controlled afterwards. With several MDT discussions,an individualized therapy was implemented and the survival was prolonged.
作者
郁佳
吴凤英
张世佳
陈淑琴
刘鸿程
武春燕
史景云
梁世雄
任胜祥
周彩存
Yu Jia Wu Fengying Zhang Shijia(Oncology Department, Shanghai Pulmonary Hospital of Tongji University, Shanghai 200433, China Respiration Medicine Department, Huaihe Hospital of Henan University, Kaifeng 475000 ,China)
出处
《实用肿瘤杂志》
CAS
2017年第4期291-296,共6页
Journal of Practical Oncology
关键词
癌
非小细胞肺/病理学
癌
非小细胞肺/诊断
基因
erb
B-1
突变
综合疗法
carcinoma
non-small-cell lung / pathology
carcinoma
non-small-cell lung/diagnosis
genes
erbB-1
mutation
combined modality therapy
