直肠癌合并原发性肺腺癌患者的MDT诊治报道

MDT diagnosis and treatment of rectal cancer with primary lung adenocarcinoma

本文介绍1例直肠癌合并原发性肺腺癌病例的多学科诊治过程。该病例完善相关检查后发现,左侧锁骨上淋巴结转移,行锁骨上淋巴结穿刺活检。病理提示,低分化肺腺癌。经多学科讨论后,患者接受化疗联合靶向药物治疗(吉非替尼250 mg,1次/d+卡培他滨1 500 mg,2次/d)。在积极治疗肺腺癌的基础上,目前已行直肠癌病灶的切除,并于胸外科规律随访。该病例的诊治过程说明,多学科诊治对于改善同时性直肠癌合并肺腺癌患者的生存至关重要,初始不可接受外科手术的患者应根据其耐受性和治疗的反应情况动态调整治疗目标。多学科诊治团队需常态化和专业化以实现患者的最大受益。

The process of muhidisciplinary team （MDT） treatment of a rectal cancer patient with primary lung adenocarcinoma was described. Left supraclavicular lymph node metastasis was discovered by clinical examination, and the bi- opsy of the lymph node indicated poorly differentiated lung adenocarcinoma. After MDT discussion, the patient received chemotherapy combined with targeted therapy（gefitinib 250 mg, once per day ＋ capecitabine 1 500 rag, twice per day）. On the basis of intensive therapy of lung adenocarcinoma, the patient received radical resection of rectal carcinoma, and is regu- larly followed up in the department of thoracic surgery. The diagnosis and treatment process of this case suggested that MDT discussion was crucial to improving the survival of patients with combined rectal cancer and lung adenocarcinoma. The treatment goal should be dynamically adjusted according to the tolerance and treatment response of patients who initially cannot tolerate surgery. MDT should be standardized and specialized to achieve the maximal benefits of patients.