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Summary: 46 -year -old men came to the hospital for cough and sputum a year ago to check the chest tablets to show the left lung occupation.Obstructive pneumonia and lung swelling are not possible.Then combine comprehensive detection (lower right lung lobe) such as bone scanning, brain enhancement of nuclear magnetic, and bronchial mirrors combined with the result of immunohistochemistry, which is in line with low -differentiation squamous cell carcinoma, which is diagnosed with advanced lung carcinoma.Remote consultation, comprehensive treatment such as chemotherapy, targeted therapy, immunotherapy, etc., a total of 6 cycles. Now our hospital continues to conduct follow -up treatment. Through comprehensive treatment such as immunotherapy, patients with cough, sputum, dyspnea, asthma and other symptoms have improved.Stable condition.
【Basic Information】 Male, 46 years old
【Disease Type】 Lung Simpancinoma
[Consultation Hospital] Jinzhong First People’s Hospital
[Time] July 2022
[Treatment Plan] Immunotherapy (Daolizumab)+targeted therapy (reorganized human vascular endothelial inhibitoryin)+radiation therapy (injecting paclitaxel)+anti -tumor (sodium sodium vitamin B6 injection)+symptomatic abolition of vomiting vomiting vomiting(Palonojan hydrochloride injection)
[Treatment cycle] 29 days of hospitalization, reviewing blood routine, liver and kidney function in 1 week, and reservation for the next treatment
[Treatment effect] Symptoms such as cough, sputum, dyspnea, asthma and other symptoms have improved, and the condition is stable
1. First diagnosis
In December 2021, the patient came to our outpatient clinic due to cough and sputum. The CT examination of the chest showed that: 1. The right lung leaf closer closer horny area, 3.0*2.0cm, consider lung cancer with the right lung leaf leaf leaf leaf leafletObstructive pneumonia and lung swelling are not possible.The bronchial mirror is recommended.2. There are many significant enlargement of large lymph nodes, 4.8*3.6cm, and the possibility of metastasis is considered.Magnetic Magnetic MRI: 1*0.6 on the left side of the bodies, considering the possibility of metastasis in combination with the history of the medical history, it is recommended to review it after treatment; the parathyry inflammation is accompanied by the left maxillary sinus cyst;Bone scan check report: The whole body’s bone metabolism is not clear.2022.1.4 Sympathetic mirror pathology: (lower right lung lobe) combined with the result of immunohistochemistry, which is in line with low -differentiated squamous cell carcinoma.After remote consultation, we suggest that the thunderbolt monocidal resistance+recombinant human vascular endothelial inhibitory+purple glycol (leukin -binding)+Luollatan treatment 1 cycle.The second cycle was adjusted to the 6 -cycle of the Reliezumab+paclitaxel+card platinum+reorganized human vascular endothelial inhibitory, and so far 6 cycles.6 cycle evaluation chest CT: 1. Combined with clinical right lung lobe occupation after treatment, the irregular soft tissue nodule stove of the lower lung back segment of the right lung, the remote fiber shadow and wedge -shaped real change of the lesion, the size is about 1.5X1.2cm is similar to the 2022-3-23 films; 2. See multiple swelling and large lymph nodes in the interval and right horny areas.It is similar to old films.2022-06-01 Magnetic Magnetic Ceremony: The tiny nodules beside the back corner of the back ventricle of the body and the maximum diameter of 3mm. Based on the medical history, the possibility of micro-cerebral metastases is high; comprehensive evaluation SD.Continue to treat my department.
Improved relevant inspections after admission, signs: ECOG score 0 points.Chronic diseases, sober consciousness, and physical cooperation. The superficial lymph nodes are not swollen, the neck is soft, the neck is in the middle, and the bilateral thyroid gland is not enlarged.The thoracic is normal, the breathing sound is clear, the sound of the wet and wet, the heart rate is 98 times/minute, the rhythm is all, the heart sounds are normal, and there is no noise.The abdomen is flat, the liver is not touched, and the spleen is not touched.The spine is normal, the activity is normal, the limbs are normal, the activity is normal, the joints are normal, and the lower limbs are not swollen.The right arm can be seen in PICC tube, and there is no redness and swelling.Auxiliary examination: Pathoscopic synopsis on the tracheal mirror: (lower right lung lobe) combined with the result of immunohistochemistry, which is in line with low -differentiated squamous cell carcinoma.Results of immune groupization: CK5/6 (-), P40 (+), CK7 (-), TTF-1 (-), napsina (-).Through comprehensive examination, the diagnosis of admission is: 1. Phase IV ct2n2m1 in the lower lung lobe iliac IV.It is recommended to continue the EP scheme chemotherapy of the six courses, and combined with radiotherapy, immunotherapy, etc., helping to control the development of the disease, the patient agrees.So I carried out the first treatment of immunotherapy, targeted therapy, and chemotherapy and radiotherapy for the patient. The choice of drugs is immunotherapy (for Relazing Mipido)+targeted therapy (reorganized human vascular endothelial inhibitory)+radiationTreatment (Pacin Patne)+anti -tumor (sodium sodium sodium vitamin B6 injection)+symptomatic abolition (Palonojano hydrochloride injection).Here is a popular immunotherapy for patients. Immunotherapy is one of the treatment methods of advanced lung cancer.For tumor immunotherapy, it has a long -lasting effect and good tolerance, but the relief rate is low, the research of biomarkers is relatively complicated, and there are individual differences.Immune tumor treatment does not directly attack cancer cells, but to resist tumors by activating the human body’s immune system. In some tumor treatment, long -term survival benefits have been displayed.It has become one of the main means of tumor treatment.Immunohistochemical inhibitors are currently the main research direction of internationally internationally of the international tumor immunotherapy. The most representative of which is PD-1/PD-L1 inhibitors and CTLA-4 inhibitors.Third, treatment effect
After receiving the treatment of three courses of treatment this time, there were mild diarrhea, the spirit was acceptable, the food was normal, there was no fever discomfort, mild fatigue, and no obvious dizziness and headache.During the process of chemotherapy, patients did not have serious discomfort. Immunotherapy, targeted therapy, chemotherapy and radiotherapy reviewed blood routine, liver function, and renal function did not see obvious abnormal indicators.After 1 week of discharge, the patient came to the hospital for review. It can be seen that the symptoms of dry cough and chest tightness have improved significantly. Then the patient’s chest CT was given to the patient. The results showed that no tumor increased and the condition was effectively controlled.The patient is instructed to check the liver and kidney function and blood routine. If the blood white blood cells are less than 4.0*10^9/L, the platelet is less than 100*10^9/L.
After the patient was treated, the symptoms of discomfort improved, and the condition was controlled. I was very happy.I have told patients to pay attention to nutrition during the treatment process, ensure nutritional balance, and focus on high protein, high -calorie, high -vitamin diets to avoid eating spicy, greasy, and cold foods.Due to the toxic side effects of chemotherapy drugs, the body’s white blood cells decrease and reduce immunity. Therefore, pay attention to keep warm and pay attention to personal hygiene to avoid infectious diseases.Maintain a good mood, establish confidence in fighting diseases, and actively cooperate with treatment.Come to the hospital regularly to observe the development of tumors in order to adjust the treatment method in time.
Five, personal perception
The advanced lung lung ofelin carcinoma suffered from patients with this patient is a type of lung cancer. It has a high degree of malignant degree, a high recurrence rate, and is very prone to distant metastasis.However, this kind of lung cancer is very sensitive to immunotherapy and radiotherapy and chemotherapy. Therefore, clinically uses immunotherapy and chemotherapy combination to effectively control the tumor to prevent the tumor from further diffusion.After immunotherapy, chemotherapy, radiotherapy, and symptomatic drugs in these cases, the disease was controlled, the tumor was not developed, and the treatment effect was good.Therefore, after the advanced period of lung squamous carcinoma, we must believe in doctors and actively cooperate with treatment. At the same time, patients must adjust their mentality, establish information from against diseases to achieve good results.In addition, the occurrence of lung squamous carcinoma is closely related to cigarettes, air pollution, and ionization radiation. In daily life, it is recommended not to smoke, avoid second -hand smoke, protect the environment, and reduce air pollution.Pay attention to the scientific diet and increase the intake of vegetables and fruits, which can effectively avoid the occurrence of lung cancer.We must believe that with the continuous advancement of science and technology, the continuous improvement of the medical level, the possibility of cure for cancer, and establishing confidence and determination to defeat cancer.