PDF(Pubmed)
Abstract：
Tumor lysis syndrome (TLS) is the rapid disintegration of a malignant tumor treated with anticancer drugs or radiation, causing electrolyte abnormalities such as elevated uric acid levels, elevated potassium and phosphorus levels, and decreased calcium levels. These abnormalities can lead to hypotension, renal dysfunction, consciousness disorders, and even death in some cases. The current patient was a 65-year-old woman who had breast cancer with local invasion, lung metastasis, and bone metastasis from the time of the initial disease onset. Despite the administration of various chemotherapy and hormone therapy regimens, the tumor increased gradually, and at 2 years and 5 months after the initial onset, pain and bleeding from metastatic infiltration of the cervical lymph nodes were noted. Therefore, radiotherapy was indicated for palliation of pain and bleeding caused by metastatic invasion of the cervical lymph nodes. Irradiation (30 Gy/10fr) was planned with a 3-field technique using 4MVX and 10MVX. Approximately 11 h after the initial irradiation, symptoms such as respiratory distress, tachycardia, and hypotension were observed. Blood tests revealed hyperuricemia and hyperkalemia, leading to a diagnosis of TLS. Dialysis and electrolyte correction were immediately initiated resulting in normalization of electrolytes and stabilization of the blood pressure. It is crucial to understand that TLS is relatively rare but can occur after radiation therapy or in solid tumors, and warrants a prompt response if suspected based on symptoms or blood findings.
摘要：
肿瘤溶解综合征（TLS）是用抗癌药物或放射治疗的恶性肿瘤的快速崩解，导致电解质异常，如尿酸水平升高，钾和磷水平升高，钙水平下降。这些异常会导致低血压,肾功能不全,意识障碍,甚至在某些情况下死亡。目前的患者是一名65岁的女性，患有局部侵袭的乳腺癌，肺转移,和骨转移从最初的疾病发作的时间。尽管有各种化疗和激素治疗方案，肿瘤逐渐增大,在初次发病后2年5个月，注意到颈部淋巴结转移浸润引起的疼痛和出血。因此,放疗用于缓解颈部淋巴结转移侵袭引起的疼痛和出血.计划使用3场技术使用4MVX和10MVX进行辐照（30Gy/10fr）。初始辐照后约11小时，呼吸窘迫等症状，心动过速,观察到低血压。血液检查显示高尿酸血症和高钾血症,导致TLS的诊断。立即开始透析和电解质校正，导致电解质正常化和血压稳定。了解TLS相对罕见，但可能发生在放射治疗后或实体瘤中，这一点至关重要。如果根据症状或血液检查结果怀疑，应迅速作出反应。
