■光免疫疗法(PIT)是一种治疗方法,其中静脉内施用西妥昔单抗沙鲁卡醇钠,然后进行激光照射。如果在表达表皮生长因子受体的肿瘤中,这种治疗表现出特定的抗肿瘤作用。无论癌症如何[Mitsunaga等人。:NatMed。2011;17(12):1685-91,佐藤等人。:ACSCentSci。2018;4(11):1559-69,Nakajima等人。:癌症科学。2018年;109(9):2889-96]。目前的适应症是不能切除的,本地先进,或局部复发的头颈癌。如果是标准治疗,如放疗和化疗,可用,他们是优先考虑的。然而,PIT的一个重要问题是与咽部水肿相关的气道紧急情况的发生。在涉及舌根的PIT的情况下,经常进行预防性气管造口术,下咽,或者喉部.
■在这项研究中,我们对一名诊断为放射诱发鼻咽癌(鳞状细胞癌(SCC)cT1N0M0I期)的患者进行经口PIT.尽管以前的病例报告和我们自己的经验没有报告鼻咽癌PIT后的气道紧急情况,我们的研究中发生了一个独特的病例[Omura等人。:AurisNasus喉部。2023;50(4):641-5,Kushihashi等人。:IntJOtolaryngol头颈外科。2022年;11(9月5日):258-65]。患者在激光照射后的清晨经历了不良的氧合和意识水平降低。鼻内镜显示上呼吸道水肿导致气道狭窄,插管具有挑战性。因此,我们进行了紧急床边气管切开术,患者的病情得到了改善。
■因此,需要注意的是,气道急症可能危及生命,作为PIT的潜在并发症,应认真监测.
UNASSIGNED: Photoimmunotherapy (PIT) is a treatment wherein intravenous cetuximab sarotalocan sodium is administered followed by laser light irradiation. This treatment exhibits a specific antitumor effect if in tumors expressing the epidermal growth factor receptor, regardless of the carcinoma [Mitsunaga et al.: Nat Med. 2011;17(12):1685-91, Sato et al.: ACS Cent Sci. 2018;4(11):1559-69, Nakajima et al.: Cancer Sci. 2018;109(9):2889-96]. The current indications are unresectable, locally advanced, or locally recurrent head and neck cancer. If standard treatments, such as radiotherapy and chemotherapy, are available, they are given priority. However, a significant concern in PIT is the occurrence of airway emergencies related to pharyngeal edema. Prophylactic tracheostomy is often performed in cases of PIT involving the root of the tongue, hypopharynx, or larynx.
UNASSIGNED: In this study, we administered transoral PIT to a patient diagnosed with radiation-induced nasopharyngeal carcinoma (squamous cell carcinoma (SCC) cT1N0M0 stage I). Although previous
case reports and our own experiences did not report airway emergencies following PIT for nasopharyngeal carcinoma, a unique
case occurred in our study [Omura et al.: Auris Nasus Larynx. 2023;50(4):641-5, Kushihashi et al.: Int J Otolaryngol Head Neck Surg. 2022;11(5, Sep):258-65]. The patient experienced poor oxygenation and a decreased level of consciousness early in the morning following the laser irradiation. Nasal endoscopy revealed airway narrowing due to upper airway edema, and intubation was challenging. Consequently, we performed emergency bedside tracheostomy and the patient\'s condition improved.
UNASSIGNED: Therefore, it is crucial to note that airway emergencies can be life-threatening and should be diligently monitored as a potential complication of PIT.