患有肺腺癌,非细菌性血栓性内心炎和多次全身栓塞的患者的长期控制:一个病例报告
Takeshi Kawakami1, Yuika Sasatani2, Sachie Hasegawa1
1Division of Respiratory Medicine, University of Tsukuba Hospital, University of Tsukuba, Tsukuba, Ibaraki 305-8576, Japan.
Experimental and therapeutic medicine
|January 26, 2024
概括
本案例研究详细介绍了高级肺腺癌与非细菌性血栓性内心炎和全身栓塞的长期治疗方法. 有效的抗凝药用阿皮克萨班控制的血栓栓塞事件超过三年.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 血液学 血液学 血液学
背景情况:
- 晚期非小细胞肺癌经常出现全身栓塞.
- 非细菌性血栓性内心炎 (NBTE) 是一种罕见但严重的并发症,与恶性瘤有关.
- 血栓栓塞栓事件对癌症患者构成重大风险,使治疗策略复杂化.
研究的目的:
- 描述一个患有肺腺癌,NBTE和多次全身栓塞的患者长期控制疾病的罕见病例.
- 在这种情况下,要突出用于血栓栓塞并发症的管理策略.
- 为类似的临床场景提出潜在的治疗方法.
主要方法:
- 一个单一中心病例报告,56岁的男性患者患有转移性肺腺癌.
- 初始治疗是 pembrolizumab,其次是肺部 IRE 和全身栓塞的管理.
- 对于血栓栓塞的事件,用肝素和随后的阿皮克萨班进行抗凝治疗.
- 随后的化学疗法用pemetrexed和bevacizumab治疗肺腺癌.
主要成果:
- 患者通过使用阿皮克萨班在3年内实现了血栓栓塞事件控制.
- 肺腺癌的完整反应是通过pemetrexed和bevacizumab实现的.
- 患者在诊断后3年内仍然处于缓解状态,没有复发迹象.
- 这位患者经历了脑瘤的伪进展和NBTE与小的大动脉植被.
结论:
- 长期抗凝药可以有效地管理NBTE肺癌患者的全身栓塞.
- 免疫疗法,抗凝固剂和化疗的组合可以在复杂的情况下导致持久的反应.
- 这一案例凸显了高级肺癌和血栓栓塞并发症患者多学科管理的重要性.
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