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Uzun süreli primeri kontrol altında beyin metastazlı küçük hücreli akciğer kanseri

Year 2020, Volume: 1 Issue: 2, 36 - 38, 30.12.2020

Abstract

Küçük hücreli akciğer kanserinde (KHAC) yaygın hastalıkta ve tedavisiz kalan hastalarda mortalite süresi ortalama 2-4 aydır. Yaygın hastalık evresinde ana tedavi seçimi kemoterapidir. Radyoterapi lokal veya metastatik hastalığa bağlı semptomların hafifletilmesi için palyatif kullanılırken, primer kitle için cerrahi nadiren kullanılır. Olgu 20 gündür olan kusma şikayeti ile tetkik edilirken alt ekstremitelerde kuvvet kaybı başlaması üzerine çekilen beyin görüntülemede intrakranial kitle tespit edilmiş Toraks bt de, sağ akciğer alt lobda 19x15 mm nodul tesbit edilmiş.Nodulden yapılan ince iğne aspirasyon biyopsi sonucu küçük hücreli akciğer karsinomu olarak geldi. Yaygın evre küçük hücreli akciğer kanseri tanısı ile tedavi planı yapıldı. Kuvvet kaybı olmasından dolayı öncelikle beyine palyatif radyoteroapi verildi. Kemoterapi başlandı. Vakanın takip sırasında tekrarlayan nüksleri olmasına ragmen yerinde kullanılan radyoterapi ve kemoterapi seçenekleri ile 32 aylık sağkalım sağlandı. KHAK , küçük hücreli olmayan akciğer kanserinden farklı olarak , klinik, patolojik ve moleküler özelliklere sahip, farklılaşmış bir nöroendokrin karsinomdur. KHAK , kemo-duyarlı bir malignitedir, bu nedenle BT görüntülemesinde ve semptomlarda ve sonuçlarda dikkate değer iyileşmeler sağlanır. Birinci basamak tedavi, ciddi toksisite riskine sahip olmasına rağmen, KHDAK ile karşılaştırıldığında performans durumu kötü olan hastalarda da yararlıdır. Hastaların çoğu (% 60-70), klinik olarak yaygın evre hastalıkla başvurur. KHAK, yaygın hastalıkta öncelikle kemoterapi ile tedavi edilmelidir ve uzak organ metastazlarında palyatif tedavi için radyoterapi veya cerrahi tercih edilmelidir. Vakada; küçük nodullerin de metastaz yapabileceği, hastalık yaygın evrede olsa dahi, lokal hastalığa yönelik tedavilerin surveye katkı sağlayabileceği akılda tutulmalıdır.

References

  • 1. Kalemkerian GP. Small Cell Lung Cancer. Seminars in respiratory and critical care medicine 2016; 37: 783-96.
  • 2. Devesa SS, Bray F, Vizcaino AP, Parkin DM. International lung cancer trends by histologic type: male: female differences diminishing and adenocarcinoma rates rising. International journal of cancer 2005; 117: 294-99.
  • 3. Antony GK, Bertino E, Franklin M, Otterson GA, Dudek AZ. Small cell lung cancer in never smokers: report of two cases. Journal of Thoracic Oncology 2010; 5: 747-48.
  • 4. Wilson LD, Detterbeck FC, Yahalom J. Superior vena cava syndrome with malignant causes. New England journal of medicine 2007; 356: 1862-69.
  • 5. Giordano KF, Jatoi A, Adjei AA et al. Ramifications of severe organ dysfunction in newly diagnosed patients with small cell lung cancer: contemporary experience from a single institution. Lung cancer 2005; 49: 209-15.
  • 6. Chute JP, Chen T, Feigal E, Simon R, Johnson BE. Twenty years of phase III trials for patients with extensive-stage small-cell lung cancer: perceptible progress. Journal of Clinical Oncology. 1999; 17: 1794-94.
  • 7. Jänne PA, Freidlin B, Saxman S et al. Twenty‐five years of clinical research for patients with limited‐stage small cell lung carcinoma in North America: Meaningful improvements in survival. Cancer 2002; 95: 1528-38.
  • 8. Jackman DM, Johnson BE. Small-cell lung cancer. The Lancet 2005; 366: 1385-96.
  • 9. Von Pawel J, Schiller JH, Shepherd FA et al. Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer. Journal of Clinical Oncology 1999; 17: 658
  • 10. Wen PY, Loeffler JS. Management of brain metastases. Oncology 1999; 13.
  • 11. Quan AL, Videtic GM, Suh JH. Brain metastases in small cell lung cancer. Oncology 2004; 18.

Small cell lung cancer with brain metastases under long-term primary control

Year 2020, Volume: 1 Issue: 2, 36 - 38, 30.12.2020

Abstract

Small cell lung cancer (SCLC) mean overall survival (OS) of patients with extensive disease without treatment is 2-4 months. Chemotherapy is the main treatment in extensive disease. Radiotherapy is used for palliation of symptoms due to local or metastatic disease, while surgery for primary mass is rarely used. Case was presented with complaint of vomiting for 20 days, and an intracranial mass was detected in the brain imaging taken due to loss of strength in lower extremities. A 19x15 mm nodule was found in the lower lobe of the right lung. Fine needle aspiration biopsy was performed, and pathological evaluation of biopsy was reported as small cell lung carcinoma. Treatment was planned according to diagnosis of extensive small cell lung cancer. The patient immediately underwent palliative cranial radiotherapy due to the loss of strength in lower extremities. Subsequently, chemotherapy were started. SCLC is a poorly differentiated neuroendocrine carcinoma with clinical, pathological, and molecular characteristics that are distinct from those of non-small cell lung cancer (NSCLC). First-line treatment, although having serious toxicity risk, is also useful in patients with poor performance status compared to NSCLC. SCLC should be treated primarily with chemotherapy in extensive disease, and radiotherapy or surgery should be preferred for palliative treatment for distant organ metastases. It should be kept in mind that small nodules can also metastasize, and even if the disease is metastatic, local treatments can contribute to survival.

References

  • 1. Kalemkerian GP. Small Cell Lung Cancer. Seminars in respiratory and critical care medicine 2016; 37: 783-96.
  • 2. Devesa SS, Bray F, Vizcaino AP, Parkin DM. International lung cancer trends by histologic type: male: female differences diminishing and adenocarcinoma rates rising. International journal of cancer 2005; 117: 294-99.
  • 3. Antony GK, Bertino E, Franklin M, Otterson GA, Dudek AZ. Small cell lung cancer in never smokers: report of two cases. Journal of Thoracic Oncology 2010; 5: 747-48.
  • 4. Wilson LD, Detterbeck FC, Yahalom J. Superior vena cava syndrome with malignant causes. New England journal of medicine 2007; 356: 1862-69.
  • 5. Giordano KF, Jatoi A, Adjei AA et al. Ramifications of severe organ dysfunction in newly diagnosed patients with small cell lung cancer: contemporary experience from a single institution. Lung cancer 2005; 49: 209-15.
  • 6. Chute JP, Chen T, Feigal E, Simon R, Johnson BE. Twenty years of phase III trials for patients with extensive-stage small-cell lung cancer: perceptible progress. Journal of Clinical Oncology. 1999; 17: 1794-94.
  • 7. Jänne PA, Freidlin B, Saxman S et al. Twenty‐five years of clinical research for patients with limited‐stage small cell lung carcinoma in North America: Meaningful improvements in survival. Cancer 2002; 95: 1528-38.
  • 8. Jackman DM, Johnson BE. Small-cell lung cancer. The Lancet 2005; 366: 1385-96.
  • 9. Von Pawel J, Schiller JH, Shepherd FA et al. Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer. Journal of Clinical Oncology 1999; 17: 658
  • 10. Wen PY, Loeffler JS. Management of brain metastases. Oncology 1999; 13.
  • 11. Quan AL, Videtic GM, Suh JH. Brain metastases in small cell lung cancer. Oncology 2004; 18.
There are 11 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Report
Authors

Esra Zeynelgil

Özlem Aydın İsak This is me

Perihan Perkin This is me

Publication Date December 30, 2020
Published in Issue Year 2020 Volume: 1 Issue: 2

Cite

APA Zeynelgil, E., İsak, Ö. A., & Perkin, P. (2020). Small cell lung cancer with brain metastases under long-term primary control. Uluslararası Modern Sağlık Bilimleri Dergisi, 1(2), 36-38.
AMA Zeynelgil E, İsak ÖA, Perkin P. Small cell lung cancer with brain metastases under long-term primary control. Uluslararası Modern Sağlık Bilimleri Dergisi. December 2020;1(2):36-38.
Chicago Zeynelgil, Esra, Özlem Aydın İsak, and Perihan Perkin. “Small Cell Lung Cancer With Brain Metastases under Long-Term Primary Control”. Uluslararası Modern Sağlık Bilimleri Dergisi 1, no. 2 (December 2020): 36-38.
EndNote Zeynelgil E, İsak ÖA, Perkin P (December 1, 2020) Small cell lung cancer with brain metastases under long-term primary control. Uluslararası Modern Sağlık Bilimleri Dergisi 1 2 36–38.
IEEE E. Zeynelgil, Ö. A. İsak, and P. Perkin, “Small cell lung cancer with brain metastases under long-term primary control”, Uluslararası Modern Sağlık Bilimleri Dergisi, vol. 1, no. 2, pp. 36–38, 2020.
ISNAD Zeynelgil, Esra et al. “Small Cell Lung Cancer With Brain Metastases under Long-Term Primary Control”. Uluslararası Modern Sağlık Bilimleri Dergisi 1/2 (December 2020), 36-38.
JAMA Zeynelgil E, İsak ÖA, Perkin P. Small cell lung cancer with brain metastases under long-term primary control. Uluslararası Modern Sağlık Bilimleri Dergisi. 2020;1:36–38.
MLA Zeynelgil, Esra et al. “Small Cell Lung Cancer With Brain Metastases under Long-Term Primary Control”. Uluslararası Modern Sağlık Bilimleri Dergisi, vol. 1, no. 2, 2020, pp. 36-38.
Vancouver Zeynelgil E, İsak ÖA, Perkin P. Small cell lung cancer with brain metastases under long-term primary control. Uluslararası Modern Sağlık Bilimleri Dergisi. 2020;1(2):36-8.