EGFR突变晚期NSCLC患者MDT诊治报道

本文介绍1例表皮生长因子受体(epidermal growth factor receptor,EGFR)突变晚期非小细胞肺癌(non-small-cell lung cancer,NSCLC)接受表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine ki-nase inhibitors,EGFR-TKIs)治疗后,肿瘤疗效不一致,后经过多次多学科讨论,接受综合诊治的经过.该患者通过经皮肺穿刺明确Ⅳ期左肺腺癌伴纵隔肺门淋巴结、双肺及脑转移,基因检测示EGFR 19外显子缺失,一线予以EG-FR-TKIs治疗.疗效考核提示左肺病灶持续有效,但右肺病灶进行性增大.右肺病灶再次活检提示鳞癌,后经化疗及右肺病灶局部放疗,双侧病灶均得到控制.患者经过多次多学科讨论,实现个体化诊疗,为患者带来生存获益.

MDT management of an advanced NSCLC patient with EGFR mutation

We report a patient with advanced non-small-cell lung cancer (NSCLC)and epidermal growth factor re-ceptor (EGFR)mutation,who showed different responses to EGFR-tyrosine kinase inhibitors (TKIs)and subsequently benefited from multidisciplinary team (MDT)management.The patient was diagnosed with stage Ⅳ adenocarcinoma of the left lung by CT guided lung puncture,with metastasis in the lung hilus,mediastina,bilateral lung and brain.Genetic screen-ing detected a deletion in exon 19 of EGFR.The patient received EGFR-TKIs as the first line therapy.After treatment,the left lung lesion showed persistent response,but the lesion in the right lung was progressively enlarged.A second biopsy from the right lung lesion revealed squamous cell carcinoma.The patient then received chemotherapy and regional radiation for the lesion in the right lung.All of the lesions were well controlled afterwards.With several MDT discussions,an individual-ized therapy was implemented and the survival was prolonged.