目的 探究顺铂同期放化疗+尼妥珠单抗治疗头颈部肿瘤的疗效.方法 以2020年1月 ～2022年12月我院收治的82例头颈部肿瘤患者为研究对象,随机分为对照组和观察组,每组各41例.对照组采用顺铂同期放化疗,观察组在对照组基础上联合尼妥珠单抗治疗;比较两组治疗效果、睡眠质量及生活质量.结果 观察组疾病客观有效率与治疗总有效率均显著高于对照组(P<0.05).护理前,两组睡眠质量各指标评分比较均无显著性差异(P>0.05);护理后,观察组入睡时间、睡眠时间、睡眠障碍、睡眠效率及睡眠质量评分均显著低于对照组(P

There is heterogeneity in cancer patients’ responses to immune checkpoint inhibitors (ICIs), including hyperprogression, which is very rapid tumor progression following immunotherapy, and pseudoprogression, which is an initial increase followed by a decrease in tumor burden or in the number of tumor lesions. This heterogeneity complicates clinical decisions because either premature withdrawal of the treatment or prolonged ineffective treatment harms patients. We presented two patients treated with ICIs with heterogeneous responses. One patient had Merkel cell carcinoma in the right thigh, and the other had nasopharyngeal squamous carcinoma. The first patient was treated with sintilimab and the second with sintilimab combined with abraxane. In the first patient, subcutaneous lesions grew substantially after the first cycle of treatment with sintilimab. In the second patient, subcutaneous lesions grew gradually after the second cycle of treatment with sintilimab combined with abraxane. In both cases, biopsy examination confirmed that newly emerged lesions were metastases of the primary tumor. These two cases remind clinicians that when subcutaneous nodules appear after treatment with ICIs, pathological biopsy is needed to determine the nature—pseudoprogression or rapid progression—of the disease course.

Multiple extracranial metastases of recurrent glioblastoma are rare and often indicate a very poor prognosis. The main conventional treatments are chemotherapy, radiotherapy, chemoradiotherapy or antiangiogenic therapy. Median overall survival is 2.3 to 6 months after the detection of extracranial metastases, and to date, there is no effective treatment for these patients. Herein, we report a recurrent glioblastoma patient with lung metastasis treated with a combination therapy containing bevacizumab and pembrolizumab due to overexpression of PD-L1 and the absence of driver mutations. The progression-free survival was 11 months from lung metastases to bone metastases. This combination treatment was further used as maintenance therapy for another 11 months after bone metastasis and secondary dorsal metastasis because there was no suitable treatment alternative. The overall survival was 27 months after lung metastases, which is much longer than previously reported cases. To our knowledge, this was the first effective use of bevacizumab plus pembrolizumab in a glioblastoma patient with extracranial metastases. Furthermore, this was the first time that bevacizumab plus pembrolizumab was used as a maintenance treatment in glioblastoma, with 11 months of response. Importantly, we showed that such combination therapy may be a novel and effective therapy for glioblastoma patients with extracranial metastases.

Introduction: Small bowel adenocarcinomas (SBAs) are rare cancers that have a distinct clinical characteristic and genetic profile. The only potentially curative treatment for localized SBAs is surgery, and treatment options are limited for patients in the advanced stage of disease. Patient concerns: A 39-year-old woman presented in October 2015 with a complaint of persistent vomiting for 8 months. Diagnosis: The patient had obstruction caused by a 3 x 2 cm mass at the ascending part of the duodenum and suspected metastasis in the right adnexal region. Postoperative pathology showed a moderately differentiated adenocarcinoma with serosal invasion. The diagnosis was stage IV duodenum adenocarcinoma with right adnexal metastasis. Interventions: After the failure of multi-line treatment with chemotherapy and targeted therapy, she was treated with the immune checkpoint inhibitor nivolumab plus regorafenib. Outcomes: Disease control lasted for 15 months with markedly improved symptoms. Conclusion: To the best of our knowledge, this is the first case of small bowel adenocarcinoma that has been treated with nivolumab combined with regorafenib. This case highlights the potential efficacy of combining nivolumab and regorafenib in the treatment of SBAs.

目的 探讨肿瘤患者及健康人群21项免疫检测指标精确检测数据.方法 选取2018年2月至2019年4月间北京丰台右安门医院收集的行精确免疫检测的人群资料进行回顾性分析,1组为健康成年人,2组为一般情况好的肿瘤患者,3组为一般情况差的肿瘤患者.均用流式细胞仪检测21项免疫指标数据,分析肿瘤患者预后与免疫指标的关系.结果 1组的细胞毒性T细胞(Tc)计数、淋巴细胞(总L)计数、总L百分比、总T计数、细胞毒/抑制T细胞(Tc +Ts)计数、总B细胞计数、辅助/诱导性T细胞(Th +Ti)计数及自然杀伤细胞(NK)计数的均值和标准差均高于2组和3组,且1组的抑制性T细胞(Ts)百分比的均值和标准差均低于2组和3组,差异均有统计学意义(均P ＜0.05).21项指标中只有Tc计数在1组与3组没有数据交叠,即1组最低值250个/μl高于3组最高值150个/μl.2组中仅1例患者末次检测后90d失访,其他患者目前均生存.3组中12例患者因疾病进展死亡,末次检测后中位生存时间为27(1～75)d.结论 多项免疫指标包括细胞毒性T细胞总数与肿瘤患者预后相关.

BACKGROUND Recently, multiple poly (ADP-ribose) polymerase (PARP) inhibitors have demonstrated excellent efficacy among patients with ovarian cancer with or without BRCA mutations. However, alternative therapeutic options are urgently required for patients who cannot benefit from conventional chemotherapy or PARP inhibitors. CASE PRESENTATION A patient with high-grade serous ovarian carcinoma presented to our clinic after developing resistance to chemotherapy. Paired tumor-normal next-generation sequencing (NGS) was performed using peripheral blood to identify potential actionable mutations. NGS revealed the patient harboring a GOPC-ROS1 fusion, which was subsequently verified using a reverse transcription polymerase chain reaction assay. No germline or somatic mutation in BRCA1/2 or mismatch repair genes was detected. Therefore, the patient received crizotinib treatment. A rapid, favorable clinical response (partial response at 1 month) was observed, with further pathological response monitored and evaluated in follow-up interrogation. CONCLUSION This study suggested that crizotinib was an off-the-shelf, practical, and ostensibly effective treatment option for patients with ovarian cancer with ROS1 rearrangement. NGS-based genetic testing may guide to plan therapeutic paradigms, and render precision medicine promising in ovarian cancer treatment. IMPLICATIONS FOR PRACTICE Despite the previous report of ROS1 fusion in patients with ovarian cancer, it remains unknown whether patients can benefit from targeted therapeutic drugs. This study reports a GOPC-ROS1 fusion identified by next-generation sequencing in a patient with chemotherapy-resistant ovarian cancer. The patient was administered crizotinib and showed rapid, remarkable response. This study suggests that comprehensive sequencing should be offered for patients with ovarian cancer without effective therapeutic strategies, and crizotinib can be used to treat ROS1-rearranged ovarian carcinomas.

目的 探讨乳腺癌脊髓转移患者的临床特点及综合治疗效果.方法 选取2008年7月至2018年6月间解放军307医院和北京丰台右安门医院收治的5例乳腺癌脊髓转移患者,脊髓病变局部治疗包括常规放疗及立体定向放疗,脊髓转移后的药物治疗包括拉帕替尼、卡培他滨、培美曲塞、替莫唑胺及氨甲蝶呤,分析患者的临床疗效和不良反应.结果 患者中4例行常规放疗,2例行立体定向放疗.脊髓转移后,2例Her-2阳性患者均采用拉帕替尼.2例患者用卡培他滨,1例用替莫唑胺,2例用培美曲塞,2例用鞘内注射氨甲蝶呤.脊髓病变治疗后,4例患者用核磁评价疗效:2例完全缓解,1例部分缓解,1例稳定,1例未评价.3例去世者脊髓转移后生存时间分别为1、5和7个月,2例存活者分别为8和129个月.结论 乳腺癌脊髓转移患者综合治疗有效,有的患者可能长期生存.

Objective:This retrospective study investigated the efficacy and safety of bevacizumab treatment for refractory brain edema.Methods:Between March 2009 and December 2015, bevacizumab was used to treat 59 cases of brain metastatic patients with refractory brain edema. The median dose of bevacizumab was 4.68mg/kg (range 2.8-6.52mg/kg). The clinical-pathological data, the efficacy, and the side effects of bevacizumab were recorded. Magnetic resonance imaging (MRI) was performed before and after bevacizumab treatment. Tumor and edema volumes were measured separately.Results:The clinical symptoms of 50 out of 59 cases (84.74%) improved the day after the bevacizumab treatment, and the edema volumes of 55 (93.22%) cases were reduced after the bevacizumab treatment. The average edema volume was significantly reduced after bevacizumab treatment from 125,583.4314,093.27 to 71,613.42 +/- 9473.42mm(3) (Mann-Whitney rank test, P<.01), and the average edema index was significantly reduced from 25.66 +/- 11.54 to 17.87 +/- 6.87 (Mann-Whitney rank test, P<.01). One patient died from a hemorrhage due to a cancerous-ulcer of the maxillary sinus. The main complication observed was hypertension, which was observed in 11 cases (18.6%).Conclusion:The effective rate of bevacizumab for refractory brain edema is 84.74%. Hypertension was the main side effect of the bevacizumab treatment. Bevacizumab is an effective and relatively safe treatment for brain edema.

Objective To observe the effects and adverse reactions of bevacizumab in brain metastases patients with serious cerebral edema. Methods Retrospective analysis of 14 cases of brain metastasis patients with serious cerebral edema, including 7 ca?ses of breast cancer, 5 cases of lung cancer, 1 case of esophagus cancer and 1 case of adenoid cystic carcinoma. Mannitol, dexametha?sone and other conventional treatment were not effective in these patients. The symptom, quality of life and the volume of edema in T2 weighted MRI images before and after the bevacizumab treatment were compared. The adverse reactions were recorded in detail. Results The medium dose of bevacizumab was 4?76 mg/kg. The symptoms of 11 cases of brain metastases were significantly relieved after the bevacizumab treatment. Brain MRI indicated that the edema volumes before and after the treatment were reduced significantly[ ( 38 804 ±14 859)mm3 vs.(80 100±28 338)mm3,P=0?02]. The edema index had a reduced trend(15?38±7?12 vs. 26?40±16?52,P>0?05). Adverse reactions associated with bevacizumab included bleeding in the nasal cavity and death in 1 patient, and hypertension in 3 pa?tient. There were no proteinuria, anemia, stomatitis and other complications. Conclusion Bevacizumab has significant efficacy for treating serious cerebral edema, but patients should be selected carefully before receiving bevacizumab to avoid serious adverse reac?tions.

INTRODUCTION Brain edema is a serious clinical event and could cause various neurological symptoms such as dizziness and headache. Drugs frequently used to relieve brain edema include steroid, dehydrant (e.g., mannitol), and diuretics. But the effects of these drugs were limited in patients with severe edema. Bevacizumab has been applied in the treatment of cerebral radiation necrosis.[1] Case studies have reported on the application of bevacizumab in the treatment of severe brain edema.[2] In the present study, we describe significant effects of bevacizumab on severe brain edema in patients with re-irradiation. MATERIALS AND METHODS All 10 patients received re-irradiation for brain tumors in the same position. The use of mannitol and hormones could not relieve the severe edema, and the quality of life was poor for these patients. Bevacizumab was administered to treat the severe edema for them. We received written informed patient consent for this procedure. The dosage of bevacizumab was given 5 mg·kg−1·time−1. Magnetic resonance imaging (MRI) was performed before and after the use of bevacizumab. The extent of edema was measured using the method of Williamson et al.[3] Three maximum edema diameters were measured in the X, Y, and Z directions in T2-weighted MRI images. The volume was estimated using the oblate spheroid formula (π/6 × XYZ). Equipment: The “moon God” gamma knife manufactured by Shenzhen ET Medical Group of China was used for stereotactic radiosurgery (SRS) of single-fraction irradiation. A CyberKnife manufactured by Accuray in America was used for fractionated stereotactic radiotherapy of 3–5 fractions irradiation. A 23EX medical linear accelerator manufactured by Varian in America was used for intensity-modulated radiotherapy and whole brain radiotherapy. Statistics: Paired t-test was used to conduct the Karnofsky Performance scale (KPS) score and edema volume between before and after treatment. RESULTS From February 2012 to November 2012, 10 patients with severe brain edema were treated with bevacizumab. The patients’ characteristics are shown in Table 1.Table 1: Patient's characteristicsNew tumor lesions were found in 2 patients more than 60 weeks. Severe brain edema may have been induced by both the tumor and re-irradiation in 2 patients. Dexamethasone and mannitol had been administrated before bevacizumab to patients for long time. The median time of follow-up was 6.5 months (3–18 months) for the survivors. There were 4 patients died include 2 from extracranial disease progression, 1 from intracranial disease progression, and 1 from bleeding of the wound surface in nasal cavity. Administration and the efficacy of bevacizumab The median times of bevacizumab treated for each patient was 3 times (range: 2–4 times). The median time between the initial use of bevacizumab and the 1st day (day 1) of the re-irrradiation was 8.3 weeks (0.6–61 weeks). The symptoms and physical signs improved significantly after treatment of bevacizumab. No. 1 patient died before the MRI re-examination. The KPS scoring and edema size were not included in the statistical analysis. MRI re-examination was carried out in the other patients after received bevacizumab. The median KPS scores before and after bevacizumab were 40 (30–60) and 70 (50–80), respectively (paired t-test P = 0.0002). Cerebral MRI indicated significant relief of edema. The median volume of the edema region on T2-weighted images before and after medication was 300.1 ml (116–382.5 ml) and 33.2 ml (7.2–321 ml), respectively (paired t-test P = 0.005). The results are shown in Table 2.Table 2: Dosage and effects of bevacizumab and follow-upBevacizumab significantly relieved severe edema induced by SRS using the CyberKnife to treat the recurrent disease for no. 5 patient. The CyberKnife treatment was 0.2 weeks and 19.1 weeks after the check time of the first MRI. Bevacizumab was given at 3.1 weeks, 6.5 weeks, 11 weeks, and 20.4 weeks. The edema volume before the initial use of bevacizumab was 382.5 ml and declined significantly after treatment each times: 323.1 ml (5.1 weeks), 97.8 ml (8.7 weeks), 171.7 ml (12.7 weeks), 79.0 ml (18.6 weeks), and 22.5 ml (21.7 weeks) [Figures 1 and 2].Figure 1: Edema volume and bevacizumab treatment time of no. 5 patient.Figure 2: T2-weighted magnetic resonance imaging of no. 5 patient before bevacizumab treatment (left) and 25 weeks later (right).Major toxicity No. 1 patient dead from bleeding of the maxillary sinus wound. The effect of bevacizumab on edema was significant for the 1st time in this patient. Bevacizumab was administered 28 days later. The drug caused sudden large bleeding from the maxillary sinus wound the next morning and the patient died from asphyxia. Cerebral infarction: Two patient with brain metastasis presented with slight to medium cerebral infarction. No. 2 patient had Colon cancer and brain metastasis and received bevacizumab on July 6 and 20, 2012. A region of cerebral infarction measuring 2 cm × 4 cm appeared at the internal capsule on the left on July 29, 2012. Muscular strength of the right limb declined to Level 3 and then recovered to Level 4 1 month later. No. 3 patient received bevacizumab on July 6 and 30, 2012. On October 14, 2012, the patient lose consciousness and in a coma for 3 days. The brain MRI indicated a region of cerebral infarction measuring 3 cm × 3 cm in the right temporal lobe. After 1-week of symptomatic treatment, the patient recovered completely. Hypertension and hyperthermia. No. 7 patient received bevacizumab 10 times for treating gliomas before re-irradiation. After each time, He experienced low fever with a maximum temperature of 37.5°C. The symptoms disappeared spontaneously after 3 days each time. The patient had no history of hypertension and did not develop hypertension during the treatment. After re-irradiation, bevacizumab was administrated once more for severe edema and caused blood pressure increasing to 150–160 mmHg/100–110 mmHg. Blood pressure decreased spontaneously to 115 mmHg/85 mmHg 4 weeks later without using antihypertensive agents. Bevacizumab treated for edema again 4.6 weeks later, and blood pressure did not increase. DISCUSSION Wang et al.[1] reported the significant efficacy of bevacizumab in the treatment of cerebral necrosis. The KPS of patients improved, and the dosage of steroid was decreased, possibly because of the relieving effect of bevacizumab on brain edema. Williams et al.[2] reported that bevacizumab had significant efficacy for treating brain edema after SRS in 1 patient. Our study included 10 patients who suffered severe brain edema after re-irradiation without the effect of steroid and mannitol. The treatment of bevacizumab quickly relieved the patients’ symptoms, and improvements of the living status were significant on the 2nd day in our study. The treatment of bevacizumab allowed us reducing the dosage of hormone and mannitol for patient with severe brain edema[4] and improving their life quality. For no. 1 patient, the efficacy lasted for 3 weeks after the first treatment of bevacizumab until the symptoms worsened. No. 4 patient received 2 times treatment of bevacizumab within 4 weeks, and the effect keep for 3–4 months until the neurological symptoms associated with cerebral edema began worsen. For no. 5 patient, bevacizumab was given 4 times in 25 weeks, and the brain edema became very slight for a long time. The dose of bevacizumab in this paper was about 5 mg/kg with a relatively long interval. The severe brain edema of 2/10 patients in our study may be caused by tumor and irradiation. Bevacizumab may be had an effect on both factors. Re-irradiation to the same site is the higher risk factor than irradiation for the 1st time that induced severe brain edema. Other factors that induced severe brain edema include irradiation dose, tumor size, tumor site and individual difference, etc. Anyway, bevacizumab could relief the brain edema significant in sorts of patients. Toxicity Authors reported that bevacizumab could cause various degrees of bleeding. Yoshida et al.[5] reported the use of bevacizumab combined with chemotherapy treating 26 patients with unresectable or metastatic colorectal cancer 1 of whom experienced grade 3 cerebral hemorrhage. Nagane et al.[6] reported bevacizumab treating 31 cases of recurrent malignant gliomas and only 1 case of asymptomatic cerebral hemorrhage with unnecessary of treatment. In our study, 1 patient with adenoid cystic carcinoma of the sinus experienced fatal hemorrhage from the wound of nasal cavity after the administration of bevacizumab 2nd times indicating that bevacizumab should be used with caution in all patients and banned for patient with wound. There is a clear correlation between cerebral infarction and bevacizumab although the conclusion is based on individual cases.[7] However, the large-sample-based data analyses by Campbell et al.[89] indicated that the incidence of ischemic stroke was not significantly different between the bevacizumab treating group and control group. Fraum et al.[10] analyzed 8 cases of ischemic stroke and concluded that the possible risk factors include hypertension, deep vein thrombosis, pulmonary embolism, arrhythmia, and dyslipidemia. In our study, no. 2 patient was diagnosed with diabetes while no. 3 patient without. Other toxicity of bevacizumab A meta-analysis by Amit et al.[11] reported that the adverse reactions associated with bevacizumab also included proteinuria (risk ratio [RR] 7.08, P < 0.00001) and hypertension (RR 4.96, P < 0.00001). One patient in our study experienced hypertension, and none developed proteinuria. In summary, the treatment of bevacizumab is effective on severe brain edema induced by re-irradiation. Bevacizumab is safe for patients whom without wounds. Our research suggests a new clinical indication of bevacizumab as treating for severe brain edema should be taken into account.

The application of high-dose irradiation to centrally-located lung tumors is generally considered to be of high risk in causing bronchial injury. The aim of the present retrospective study was to investigate the safety and efficacy of stereotactic body radiation therapy (SBRT) for patients with centrally-located lung tumors. In total, 28 patients who underwent SBRT for lung tumors within 2 cm of a major bronchus were retrospectively analyzed. The median total dose prescribed was 45 Gy (range, 36.3-52.5 Gy), the median fraction was 12 (range, 10-15) and the median dose per fraction was 3.6 Gy (range, 3-5 Gy). The median follow-up period for the surviving patients was 14 months (range, 10-41 months). The local control rate of SBRT was 100%, with a complete response (CR) rate of 32.1% (9/28); a partial response (PR) rate of 50% (14/28) and a stable disease (SD) rate of 17.9% (5/28). In total, 15 patients survived and 13 patients succumbed; 11 patients succumbed to tumor progression, one to congestive heart failure and one to a brain hemorrhage. The main side-effects included grade 2 esophagitis (17.9%; 5/28) atelectasis (10.7%; 3/28) and grade 2 late radiation pneumonitis (7.1%; 2/28). Severe late toxicity (≥ grade 3) was not observed in any patient. SBRT is an effective and safe therapy for centrally-located lung tumors.

Objective: Radiation recall dermatitis (RRD) occurs in a previously irradiated field and is triggered by certain cytotoxic drugs or target drugs. A case of RRD caused by treatment with erlotinib 21 days after whole brain radiation therapy (WBRT) is reported. PATIENT AND Methods: A 56-year-old female patient with boon metastase of non-small cell lung cancer (T3N2M1) was found brain metases in MRI without symptom 3 months after diagnosis. She was treated with WBRT (Dt40Gy/20f/4weeks) and erlotinib (150mg/day) thereafter. Results:The patient developed rash, folliculitis and localized infection in her head skin 21 days after the first dose of erlotinib (grade 3 Radiation Therapy Oncology Group scoring criteria). The severity lesions were localized to head skin which limited in scope of WBRT. Erlotinib was stop and treatment to lesions was applied. The diagnosis of RDD induced by erlotinib was made. Conclusion:The use of Erlotinib after RT may trigger RRD. We advise clinicians to be cautious of RRD after erlotinib treatment. The drug should be unused and the treatment to severity lesions should be applied.

Objective To compare dose distribution in gamma knife radiotherapy plan, conformal radiotherapy(CRT)plan and intensity modulated radiotherapy(MRT)plan for patients with small mass in lung, and evaluate their characters. Methods Fourteen patients with small mass in lung participated in the study. Gamma knife radiotherapy plan(plan 1), CRT plan(plan 2)and IMRT plan(plan 3)were made for each mass. The planning target volume(PTV)and the dose include 95% PTV were consistent.Conformal index(CI), homogeneity index(HI), lung V5 ,V10 ,V20 ,V30 and the max dose of esophagus and spinal cord were analyzed. Paired samples t-test was used for comparison between each two plans. Results The CI of the plan 1,2 and 3 were 0. 58,0. 46 and 0. 63, respectively. CI of the plan 1 ＞ that of the plan 2 (t= -3.95,P =0.000),plan 3 ＞ plan 2(t = -6.01 ,P =0.000),plan 1 =plan 3(t =1.64,P =0.116);HI of the plan 1,2 and 3 were 1.66,1.10 and 1.07 respectively. HI of the plan 1 ＞ plan 2 ,plan 1 ＞ plan 3(t= -20.52,21.41 respectively, both P=0. 000),plan 2 = plan 3(t= -1.08,P=0.294). The wholelung V5 ,V10 ,V20 and V30 were 10.0% ,5.6% ,2. 4% and 1.2%, respectively, in plan 1 ;20. 2% ,13. 4%,6. 9% ,3.0%, respectively, in plan 3; and 26. 5%, 18. 0%, 11.4% and 4. 6%, respectively, in plan 2.The V5, V10, V20 and V 30 of the plan 1 ＜ in plan 2(t = 9. 68,8. 41,5. 45,5. 14, all P = 0. 000), the V5,V10,V20 and V30 of the plan 1 ＜ in plan 3(t=7.58,8.95,6. 15,4.78, respectively, all P=0.000),the V5 ,V10, V20andV30 oftheplan2 ＞ inplan3(t =9. 71,5. 91,4. 13,3.91, respectively, allP =0.000).The max dose of esophagus in plan 1 ,2 and 3 were 24.93 ± 21.54, 31.90 ± 18. 75, 29. 19 ± 23.09 Gy,respectively, plan 1 ＜ plan 2(t = -2. 71 ,P=0.013),plan 1 = plan 3(t = - 1.49,P =0. 152),plan 2 =plan 3(t = 1.35, P = 0. 193). The max dose of spinal cord in plan 1,2 and 3 were 12.07 ± 10. 67,17.70 ±11.35 and 8.92 :± 10. 04 Gy, respectively, plan 2 ＞ plan 1 ＞plan 3(t = -2. 38,2. 29,4. 83,P=0. 1027,0.033,0.000);All three plans of each mass meet the needs that the max dose of the esophagus≤60 Gy and the max dose of spinal cord ≤40 Gy. Conclusions The dose of the normal lung was lower, but the HI and the max dose of spinal cord were higher in Gamma knife radiotherapy plan than those in the CRT and the IMRT plan of the small mass in lung.

约有14%的低钠血症患者与肿瘤存在相关性,会发生抗利尿激素分泌异常综合征(SIADH).因此,在临床工作中,应积极抗肿瘤治疗,有助于改善患者的预后及提高生活质量.现将我科近年收治的3例肺癌合并低钠血症患者临床资料回顾分析如下.

患者男,54岁,2006年11月行左肺切除术,术后病理为鳞癌,后未继续治疗.2009年5月发现左胸壁一约0.5 cm×0.5 cm大小肿物,未予重视,发展迅速,逐渐长到约2.5 cm×2.5 cm大小.一般状态不佳,呈恶病质,KPS 60分.