PDF(Pubmed)
Abstract：
UNASSIGNED: Brain metastases (BMs) are common in Small Cell Lung Cancer (SCLC), but the prognosis is very poor. Currently, there is no standard of care on what constitutes optimal treatment, and there is no consensus regarding maintenance therapy in SCLC.
UNASSIGNED: We report the case of a 55-year-old man with advanced SCLC. After the initial diagnosis, he received routine chemotherapy and chest radiotherapy but developed brain metastases with 2 lesions seven months later. We used an effective combination therapy consisting of the antiangiogenic inhibitor, Anlotinib and whole-brain radiotherapy. We then administered anti-PD-L1 immunotherapy Atezolizumab in combination with Anlotinib as long-term maintenance therapy. Twelve months later, there was a progression in one of the brain metastases. The patient underwent further stereotactic radiotherapy (SRT) for the lesion. However, after four months of treatment with SRT, the lesion began to gradually grow in size. The patient underwent surgical resection of the lesion, which confirmed radioactive brain necrosis. After a full 3-year course of anti-PD-L1 therapy, the patient discontinued immunotherapy and was administered only Anlotinib as maintenance. At the time of writing up this report, the patient was alive and the overall survival reached 41 months after the onset of BM.
UNASSIGNED: This indicated a potential synergistic effect of combined immunotherapy and antiangiogenic targeted therapy with local radiotherapy in patients with BM-SCLC and can provide directions for future clinical decisions.
UNASSIGNED: We report the case of a 55-year-old man with advanced SCLC. After the initial diagnosis, he received routine chemotherapy and chest radiotherapy but developed brain metastases with 2 lesions seven months later. We used an effective combination therapy consisting of the antiangiogenic inhibitor, Anlotinib and whole-brain radiotherapy. We then administered anti-PD-L1 immunotherapy Atezolizumab in combination with Anlotinib as long-term maintenance therapy. Twelve months later, there was a progression in one of the brain metastases. The patient underwent further stereotactic radiotherapy (SRT) for the lesion. However, after four months of treatment with SRT, the lesion began to gradually grow in size. The patient underwent surgical resection of the lesion, which confirmed radioactive brain necrosis. After a full 3-year course of anti-PD-L1 therapy, the patient discontinued immunotherapy and was administered only Anlotinib as maintenance. At the time of writing up this report, the patient was alive and the overall survival reached 41 months after the onset of BM.
UNASSIGNED: This indicated a potential synergistic effect of combined immunotherapy and antiangiogenic targeted therapy with local radiotherapy in patients with BM-SCLC and can provide directions for future clinical decisions.
摘要：
■脑转移（BMs）在小细胞肺癌（SCLC）中很常见，但预后很差.目前,关于什么是最佳治疗没有标准的护理，对于SCLC的维持治疗尚无共识.
■我们报告一例55岁男性晚期SCLC。初步诊断后,他接受了常规化疗和胸部放疗，但7个月后发生了2个病灶的脑转移。我们使用了一种有效的联合疗法，包括抗血管生成抑制剂，安洛替尼和全脑放疗。然后，我们给予抗PD-L1免疫治疗阿替珠单抗联合安洛替尼作为长期维持治疗。十二个月后,其中一个脑转移有进展。患者对病变进行了进一步的立体定向放射治疗（SRT）。然而,用SRT治疗四个月后，病变开始逐渐增大。患者接受了病灶的手术切除,证实放射性脑坏死.经过整整3年的抗PD-L1治疗，患者停止免疫治疗,仅接受安洛替尼维持治疗.在撰写这份报告时，患者在BM发病后存活,总生存期达到41个月.
■这表明在BM-SCLC患者中，联合免疫治疗和抗血管生成靶向治疗与局部放疗的潜在协同作用，可以为未来的临床决策提供指导。
■我们报告一例55岁男性晚期SCLC。初步诊断后,他接受了常规化疗和胸部放疗，但7个月后发生了2个病灶的脑转移。我们使用了一种有效的联合疗法，包括抗血管生成抑制剂，安洛替尼和全脑放疗。然后，我们给予抗PD-L1免疫治疗阿替珠单抗联合安洛替尼作为长期维持治疗。十二个月后,其中一个脑转移有进展。患者对病变进行了进一步的立体定向放射治疗（SRT）。然而,用SRT治疗四个月后，病变开始逐渐增大。患者接受了病灶的手术切除,证实放射性脑坏死.经过整整3年的抗PD-L1治疗，患者停止免疫治疗,仅接受安洛替尼维持治疗.在撰写这份报告时，患者在BM发病后存活,总生存期达到41个月.
■这表明在BM-SCLC患者中，联合免疫治疗和抗血管生成靶向治疗与局部放疗的潜在协同作用，可以为未来的临床决策提供指导。
