Sintilimab plus chemotherapy achieved symptom relief in stage IV lung squamous cell carcinoma with superior vena cava syndrome: a case report
Sintilimab plus chemotherapy achieved symptom relief in stage IV lung squamous cell carcinoma with superior vena cava syndrome: a case report
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DOI：
10.21037/apm-21-3674
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发表时间：
2022-01-14
影响因子：
--
通讯作者：
Ke, Xixian
中科院分区：
文献类型：
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作者：
Guo, Liuning;Qu, Wendong;Ke, Xixian
肺癌是世界上第二大常见和致死性疾病。大多数肺癌患者确诊时已是晚期。晚期肺癌有多种治疗方法。其中，免疫治疗加化疗逐渐成为一线治疗。肺癌有多种并发症，上腔静脉综合征(SVCS)是晚期肺癌患者常见的并发症。目前的治疗方法包括放射治疗、化疗和支架植入。支架植入术具有侵袭性大、疗效差等缺点。免疫治疗作为一种新兴的肿瘤治疗方法，在晚期肺癌患者的治疗中显示出显著的优势。然而，使用免疫疗法治疗晚期肺癌合并上腔静脉综合征的报道很少。在此，我们报告一位48岁男性第四期(T4N3M1)肺鳞状细胞癌患者。辛替利单抗联合化疗1周期(3周)后，肿瘤肿块缩小30%，部分缓解(PR)，形成侧支循环，SVC引起的症状大部分消失。治疗3个周期后，肿瘤缩小近90%，上下腔静脉开口较治疗前增大。我们的病例为此类患者提供了一种新的治疗策略。
Lung cancer is the second most common and mortality disease in the world. Most patients with lung cancer are already at the advanced stage when diagnosed. There are multiple treatments for advanced lung cancer. Among them, immunotherapy plus chemotherapy has gradually become the first-line treatment. Lung cancer has multiple complications, superior vena cava syndrome (SVCS) is a common complication of patients with advanced lung cancer. The current treatments include radiotherapy, chemotherapy, and stent implantation. Stent implantation has the disadvantages of invasiveness and poor efficacy. Immunotherapy, as an emerging treatment for tumors, has shown significant advantages in treating patients with advanced lung cancer. However, the treatment of advanced lung cancer with SVCS using immunotherapy has rarely been reported. Here, we reported a 48-year-old male patient with stage IV (T4N3M1) lung squamous cell carcinoma. After receiving 1 cycle (3 weeks) of comprehensive treatment with sintilimab plus chemotherapy, the tumor mass shrank by 30% to achieve partial response (PR), collateral circulation was formed, and most of the symptoms caused by SVCS disappeared. After 3 cycles of treatment, the tumor shrank by nearly 90%, and the superior and inferior vena cava opened larger than before. Our case provides a novel treatment strategy for such patients.