PDF(Pubmed)
Abstract：
Patients on dialysis have limited treatment options for advanced lung cancer because some chemotherapeutic agents are unavailable due to renal dysfunction. A man in his 70s on peritoneal dialysis presented with persistent fever refractory to antibiotics for 2 weeks. Subsequent whole-body CT showed a 5 cm diameter mass in the right lower lobe of the lung with right-sided pleural effusion and osteolytic metastasis of the right iliac bone. The patient was diagnosed with squamous cell carcinoma (cT3N2M1b, stage IVB) harbouring the p.Gly719Ala point mutation on exon 18 of the epidermal growth factor receptor. The patient developed severe respiratory failure due to malignant lymphangitis after a bronchoscopy. He received 30 mg/day of afatinib, resulting in tumour shrinkage and recovery from respiratory failure. We advocate for aggressive screening of driver oncogenes in patients with lung cancer on dialysis, including those with squamous cell lung cancer.
摘要：
透析患者对晚期肺癌的治疗选择有限，因为某些化学治疗剂由于肾功能不全而无法使用。一名70多岁的腹膜透析男子表现出持续发烧，对抗生素耐药2周。随后的全身CT显示肺右下叶直径为5厘米的肿块，右侧胸腔积液和右骨溶骨转移。患者被诊断为鳞状细胞癌（cT3N2M1b，IVB阶段）在表皮生长因子受体的外显子18上带有p.Gly719Ala点突变。患者在支气管镜检查后由于恶性淋巴管炎出现严重呼吸衰竭。他接受了30毫克/天的阿法替尼，导致肿瘤缩小和呼吸衰竭的恢复。我们提倡在透析的肺癌患者中积极筛查驱动癌基因，包括鳞状细胞肺癌患者.
