PDF(Pubmed)
Abstract：
Pseudoprogression is rarely mentioned after radiotherapy except for central nervous system tumors. With the widespread of immunotherapy, the incidence of pseudoprogression of thoracic tumor after radiotherapy is increasing. This study summarized the clinical features of pseudoprogression in 4 patients who had underwent thoracic radiotherapy after and/or followed by immunotherapy. All of them had received chemotherapy and immunotherapy before thoracic radiotherapy. After radiotherapy, pseudoprogression occurred within 3 months after initiation of immune consolidation/rechallenge therapy. At least a 20% increase in the sum of the longest diameter of target lesions were measured on their chest image. During this period, patients\' ECOG PS scores remained stable, specific serum tumor markers did not increase significantly. Treatment strategies did not change after pseudoprogression. The causes of radiographic pseudoprogression in this case series may be attributed to disturbances such as pneumonitis, atelectasis, mucus blockages and infection. In the era of immunotherapy, pseudoprogression of thoracic tumors after chest radiotherapy might become a common phenomenon. It is important for us to identify pseudoprogression based on patient\'s general status, radiological changes, and laboratory tests.
摘要：
除中枢神经系统肿瘤外，放疗后很少提及假性进展。随着免疫疗法的普及,胸部肿瘤放疗后假性进展的发生率正在增加。本研究总结了4例接受胸部放疗后和/或随后接受免疫治疗的患者假性进展的临床特征。所有患者均在胸部放疗前接受过化疗和免疫治疗。放疗后,假性进展发生在免疫巩固/再激发治疗开始后3个月内。在其胸部图像上测量到目标病变的最长直径的总和至少增加了20％。在此期间,患者ECOGPS评分保持稳定，特异性血清肿瘤标志物没有显著增加.治疗策略在假性进展后没有改变。在这种情况下，影像学假性进展的原因可能归因于诸如肺炎之类的干扰，肺不张,粘液阻塞和感染。在免疫疗法时代,胸部放疗后胸部肿瘤的假性进展可能成为一种普遍现象。对我们来说，根据患者的一般状况识别假性进展是很重要的，放射学变化，和实验室测试。
