A 64 -year -old patients with patients who cannot surgery can only be chemotherapy for treatment process
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Summary: 64 -year -old men have symptoms such as chest tightness and asthma 6 years ago. They did not care and did not treat them. They were discovered in the local hospital in September 2020 due to physical discomfort.The symptoms improved.In 2022, the CT reminder: The lesions of the left lung tip occupy the lesions increased compared to the previous, considering progress, and the first ribs on the left were damaged.Combined with related examinations, the diagnosis of lung squamous carcinoma is accompanied by metastasis.According to the patient’s condition, Duocisai, cisplatin injection solution single drug chemotherapy to relieve pain, anti -bone metastasis, and give sodium sodium sodium vitamin B6 injection to assist anti -tumors, and use methamphetamine for spitting and other symptoms.After comprehensive treatment, the patient’s discomfort improved and the condition was stable.
【Basic Information】 Male, 64 years old
【Disease Type】 Lung Simpancinoma
[Consultation Hospital] Jinzhong First People’s Hospital
[Time] July 2022
[Treatment Plan] Chemotherapy drugs (Dorcica, Cisplatin injection)+anti -tumor drugs (sodium sodium sodium sodium vitamin B6 injection)+antivirus (methaxoline injection)
[Treatment cycle] 14 days of hospitalization treatment
[Treatment effect] Patient’s condition is effectively controlled
1. First diagnosis
The 64 -year -old man in the patient, “6 years due to chest tightness and breath for 6 years” in September 2020.Check the results of the chest CT examination: 1. Considering the left lung tip position (lung cancer may be large), the left pulmonary lymph nodes are enlarged, please combine clinical and related examinations; 2. The possibilities of fine pilotitis of the upper lung and lower left lobe.Line lung puncture biopsy at 2020-09-23, pathological tips: left lung squamous carcinoma, medium division.Immunization: CK5/6 (+) P40 (+) CK7 (-) Napsina (-) P53 (+3%) Ki-67 (+10%) CGA (-) Syn (-).Combined with imaging, diagnosis is: left lung squamous carcinoma with left pulmonary lymph nodes metastasis IIIB stage.2020-9-30/10-22 Perform the first and 2nd cycles of “white protein paclitaxel+cisplatin” systemic chemotherapy, the first cycle of the protein paclitaxes of the liquid infusion of the liquid of the skin, the skin itching on the chestEssenceReviewing the chest CT prompts the left lung lesion: 3.8*3.4cm. Comprehensive evaluation lesion to PR.2020-11-14/12-5 Line 3 and 4 cylinder “White protein paclitaxel 300mgd1+pro-platinum 50mgd1-D3/21D” systemic chemotherapy.On the third day after chemotherapy, the merit and digestive tract reactions were caused, and the symptomatic treatment was improved.In 2022, the CT reminder: The lesions of the left lung tip occupy the lesions increased compared to the previous, considering progress, and the first ribs on the left were damaged.Today, in order to clarify the progress of tumor and the next treatment plan, experts are asked to consult and guide the next treatment plan.
2. Treatment
After admission, patients are admitted to specialist examination: no abnormal bulge or depression, no deformity of the thorax, no tenderness in the chest, no lumps, normally expansion of the thoracic, no pleural friction, normal breathing sound, no dry and wet elastic sound and abnormal breathing sound.The lung world is normal, and the mobility of the lower part of the lungs is normal.Specialty chest CT reminder: Patients after lung cancer chemotherapy, compared with 2022-05-25 tablets, the current film shows that there is an irregular group shadow in the left lung tip.The intercostal, near the first rib, can be seen, which is slightly larger than the front film.See multiple solid nodules (SE4: IM141, IM258). The larger ones are located in the lower lung leaf (SE4: IM141), with a size of about 3mmx2mm.Right lung leaf (SE4: TM134), right lung lobe (SE4: IM195), left lung leaf (SE4: IM265) see multiple pure milling glass nodules.The size is about 8mmx6mm.A cystic translucent shadow can be seen in the bottom of the left lung leaf, and the boundary is clear.The longitudinal structure is centered.Swelling lymph nodes can be seen inside.The shape of the heart shadow is normal.There is no effusion in the pericardium and bilateral chest cavity.T7 vertebral body is visible to the shape of the shape.T11 vertebrae can be visible to nodular high -density shadows.There are multiple high -density shadows in the gallbladder.Combined with medical history and examination reports, diagnosis is: left lung squamous cell carcinoma.Because this disease is a stage IIIB pulmonary squamous carcinoma, it is more serious and progress is rapid.When communicating with the family members of the patient, avoid being heard by the patient, and inform the disease of the disease. The patient currently loses the opportunity of surgery and has chemotherapy indicators. It is recommended to continue to chemically treat the whole body.After discussion, patients and their families agreed to perform chemotherapy. The chemotherapy scheme was Dostcita, cisplatin, and giving sodium sodium sodium vitamin B6 injection to auxiliary anti -tumors.Evil, anti -allergic, kidney protection and liver and other symptoms. In the process of chemotherapy, nausea and vomiting occur, timely metharine to stop vomiting, and timely treatment of patients to prevent allergies in time.
Third, treatment effect
After the preliminary treatment of 3 cycles, the patient returned to the hospital for review. In the past 6 weeks, the body weight increased by 3kg. The symptoms of cough were significantly improved compared to the previous. The size of the primary tumor to enhance the re -examination was significantly reduced compared with the front.The clinical staging assessment shows that the patient’s tumor staging is stable from the IIIB stage to the IIIA stage.Tumor logo reminds that the carcinoma antigen is significantly reduced to indicate that the patient’s internal tumor cell copy and proliferation is obviously controlled.Combined with the patient’s examination, after the patient conducts systemic chemotherapy, the internal tumor is effectively controlled. Patients need to continue to receive comprehensive treatment of systemic chemotherapy and stable condition.Fourth, precautions
After the patient was treated, the symptoms of discomfort improved, and the condition was controlled. I was very happy.I told patients to pay attention to the light diet, high protein diet, and balanced nutrition during the treatment process.You can eat more eggs, fish, beans, etc.After discharge, the blood routine and liver and kidney function are regularly reviewed. Pay attention to the number of white blood cells and platelets. If the number is too low, it is necessary to go to the hospital for treatment in time.Passing the adverse reactions after the chemotherapy: nausea and vomiting, lumbar acid and abdominal distension, platelet decreased, liver and kidney damage, bleeding, etc.Patients should take a full rest, avoid tiredness, try to relax as much as possible, and actively face treatment.Clarify the changes in the condition, and actively participate in treatment if there are abnormalities.
Five, personal perception
Although the patient in this case is a late tumor period, it has basically lost the opportunity to surgical treatment, and the type of tumor tumor tumor is squamous carcinoma, which belongs to the type that is as low as moderate sensitive to chemotherapy drugs.Get obvious control, the treatment effect is good.This shows that the same type of tumor does not need to be treated according to the traditional treatment method. It should be individualized. Therefore, for different tumor patients, it should be based on its own situation.To the cause of the person.The whole body chemotherapy of the lung squamous carcinoma is suitable for patients with clinical stages IIIB and later, but there will be more side effects in the drugs used in chemotherapy, such as bone marrow suppression, allergic reactions, edema, nausea and vomiting and other gastrointestinal tract reactions.Therefore, we must pay attention to the symptomatic treatment in time during treatment.At the same time, it is recommended that patients treated in a timely treatment after discovering the lungs.In the process, the cooperation of family members is very important. The patients are very anxious and irritable after learning the condition, but the children are very patient. Under the care of the family, they have better recovery. There are some side effects after chemotherapy, which is also processed in time.Through this case, I hope that everyone will go to the hospital for diagnosis and treatment in time after the symptoms appear. If this patient can come to the hospital as soon as possible, it may be able to use a better treatment, alleviate the condition earlier, and reduce the symptoms.
