PDF(Pubmed)
Abstract：
Non-small-cell lung cancer (NSCLC) is the most common cancer in the world. In recent years, the incidence of synchronous multiple primary lung cancer (SMPLC) has gradually increased. Surgery is the preferred method to treat these patients. The management of SMPLC patients who cannot tolerate surgical treatment is controversial. We report a rare case in which a 70-year-old Chinese woman with no history of smoking had three primary lung adenocarcinoma lesions. Two lesions had epidermal growth factor receptor (EGFR) exon 19 deletion mutations, and one lesion had the L858R mutation. After first-generation EGFR-tyrosine kinase inhibitor (TKI) treatment, the three lesions all showed a good response until disease progression. After the corresponding drug treatments were given based on the different drug resistance mechanisms, good responsiveness was shown in each lessions. This case suggests that in the treatment of SMPLC, it is necessary to learn the molecular-biological information of each lesion due to the differences thereof, and a targeted treatment regimen should be developed on this basis.
摘要：
非小细胞肺癌（NSCLC）是世界上最常见的癌症。近年来,同步性多原发肺癌（SMPLC）的发病率逐渐升高。手术是治疗这些患者的首选方法。不能耐受手术治疗的SMPLC患者的管理存在争议。我们报告了一个罕见的病例，其中一名70岁的中国女性没有吸烟史，有三个原发性肺腺癌病变。2个病灶有表皮生长因子受体(EGFR)第19外显子缺失突变,一个病变有L858R突变。第一代EGFR酪氨酸激酶抑制剂（TKI）治疗后，3个病灶均表现出良好的反应,直至疾病进展.根据不同的耐药机制给予相应的药物治疗,在每次会议中都表现出良好的反应。该病例表明，在SMPLC的治疗中，由于每个病变的差异，有必要学习每个病变的分子生物学信息，并在此基础上制定有针对性的治疗方案。
