肺肉瘤样癌术后迅速多发转移行免疫联合治疗1例

Pulmonary Sarcomatoid Carcinoma With Rapid Multiple Metastases After Operation Treated With Combined Immunotherapy:A Case Report

肺肉瘤样癌(pulmonary sarcomatoid carcinoma,PSC)是一种少见、分化较差的非小细胞肺癌(nonsmall cell lung cancer,NSCLC),手术根治切除是早期主要的有效治疗手段,中期能切除者以手术切除为主的综合治疗,不能切除者以根治性放化疗为主,对于晚期则根据肿瘤病理类型及基因检测的结果制定个体化的全身治疗方案。目前的大多数研究表明PSC患者的预后比其余的NSCLC患者更差。随着分子检测技术在临床的广泛应用,发现69%~80%PSC患者包含至少一个基因突变。本文为陕西省人民医院肿瘤内科收治的PSC术后迅速多发转移患者,通过基因检测指导治疗,患者获得较明显的缓解,报道其诊疗过程以期为PSC治疗提供临床参考。

Pulmonary sarcomatoid carcinoma(PSC)was a rare,poorly differentiated non-small cell lung cancer(NSCLC),for which radical surgical resection was the main effective treatment in the early stage.For those who can be resected in the middle stage,surgery was the main comprehensive treatment,however,those who cannot be resected are treated mainly with radical radiotherapy.For advanced stages,individualized systemic treatment protocols were developed based on tumor pathology and genetic testing results.Most of the current studies have shown that the prognosis of PSC patients was worse than the rest of NSCLC patients.With the widespread use of molecular testing techniques in clinical practice,69%to 80%of PSC patients were found to contain at least one genetic mutation.In this paper,a patient with rapid multiple metastases after PSC surgery admitted to the Department of Medical Oncology of Shaanxi Provincial People’s Hospital was treated with genetic testing to guide treatment,and the patient achieved more significant remission,and the treatment process was reported in order to provide clinical reference for PSC treatment.