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放疗联合Keytruda、GM-CSF治疗晚期结肠癌1例报道并文献复习 预览

One case report of advanced colon cancer treated with radiotherapy combined with Keytruda,GM-CSF and literature review
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摘要 目的:探讨放疗与PD-1抑制剂Keytruda、粒细胞-巨噬细胞集落刺激因子(granulocyte-macrophage colony stimulating factor,GM-CSF)三者联合治疗晚期结肠癌的疗效及相关不良反应,以提高临床医师对放疗与免疫治疗联合的认识。方法:总结1例男性晚期结肠癌并皮下多发转移及骨转移患者,对靶向治疗不敏感且拒绝化疗,为减轻腰椎疼痛及防止皮下肿块破溃,给予腰椎骨转移灶及右侧腹壁、左大腿根部皮下两个结节(直径约2.5cm和3cm)放疗,右侧腹壁肿块瘤周皮下给予GM-CSF(200 μgq d),全身给予Keytruda(100 mg ivgtt d1)治疗。观察其病情演变及转归,并复习相关文献。结果:治疗后可观察到全身皮下肿块逐渐缩小,腰椎疼痛缓解,但血小板出现迅速、不可逆性下降。结论:放疗与PD-1抑制剂Keytruda、GM-CSF三者联合治疗晚期结肠癌疗效显著,但需警惕其免疫相关性不良反应。 Objective: To discuss the effect and adverse reactions of radiotherapy combined with Keytruda and GM-CSF for advanced colon cancer,and to improve the understanding of radiotherapy combined immunotherapy for clinicians. Methods: The authors describe a male patient of advanced colon cancer with bone and multiple-subcutaneous metastasis who was not sensitive to targeted therapy and refused to chemotherapy.To relieve the pain of lumbar spine and prevent the rupture of the subcutaneous metastasis,we gave radiotherapy to lumbar spine and two subcutaneous metastasis on the right side of the abdominal wall and left thigh (diameter is about 2.5 cm and 3 cm),and subcutaneous injected GM-CSF (200 μg qd) to the right side metastasis of the abdominal wall,at the same time giving Keytruda (100 mg ivgtt d 1) treatment.We report the disease evolution and outcome after treatment,and review the related literature. Results: After the treatment,the subcutaneous metastasis was gradually reduced,and the pain of the lumbar spine relieved,but the platelets declined rapidly and irreversibly. Conclusion: The effective of radiotherapy combined with Keytruda and GM-CSF is significant,but we need pay more attention to immune related adverse reaction.
作者 黄胜兰 姚伟荣 曾麟 万会平 Huang Shenglan;Yao Weirong;Zeng Lin;Wan Huiping(Department of Oncology,Jiangxi Provincial People's Hospital,Jiangxi Nanchang 330006,China)
出处 《现代肿瘤医学》 CAS 2019年第4期623-626,共4页 Modern Oncology
关键词 结肠癌 放疗 Keytruda GM-CSF colon cancer radiotherapy Keytruda GM-CSF
作者简介 黄胜兰(1990-),女,江西吉安人,医师,硕士,主要从事肿瘤的放化疗及免疫治疗工作。E-mail:421990300@qq.com;通讯作者:姚伟荣(1978-),女,山东威海人,主任医师,博士,主要从事肿瘤精确调强放疗及个体化化疗、免疫治疗工作。E-mail:yaoweirong2901@126.com
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