内容紹介
Summary
An 81-year-old man was admitted to our medical center for dyspnea. He underwent right upper lobectomy due to squamous cell lung cancer 5 years ago. Chest computed tomography(CT)revealed stenosis of the right main bronchus, and pathological diagnosis of the lesion was squamous cell carcinoma and PD-L1 expression was low(tumor proportion score[TPS]: 1%). Because his performance status(PS)was 1, he underwent 4 courses of nab-paclitaxel(nab-PTX)plus carboplatin(CBDCA)plus pembrolizumab chemotherapy and pembrolizumab maintenance chemotherapy. The stenosis of the right main bronchus was clear after chemotherapy, and his dyspnea was improved. Chemotherapy using nab-PTX plus CBDCA plus pembrolizumab may become one of the therapeutic choices for the recurrence after operation of an elderly person with squamous cell lung carcinoma and low PD-L1 expression.
要旨
症例は81歳,男性。呼吸困難にて当医療センターに入院した。5年前に右上葉扁平上皮肺癌にて右上葉切除術を施行されていた。胸部CTでは右主気管支の狭窄を認め,病理組織学的診断は扁平上皮癌であった。PD-L1発現はTPS 1%で低発現であった。患者はPS 1であったため,nab-PTX+CBDCA+pembrolizumab化学療法を4コース施行し,その後pembrolizumabによる維持療法を行った。化学療法後,右主気管支の狭窄は消失し,呼吸困難も改善した。nab-PTX+CBDCA+pembrolizumab化学療法は,PD-L1低発現である高齢者扁平上皮肺癌術後再発に対して治療方法の選択肢の一つとなる可能性がある。
目次
An 81-year-old man was admitted to our medical center for dyspnea. He underwent right upper lobectomy due to squamous cell lung cancer 5 years ago. Chest computed tomography(CT)revealed stenosis of the right main bronchus, and pathological diagnosis of the lesion was squamous cell carcinoma and PD-L1 expression was low(tumor proportion score[TPS]: 1%). Because his performance status(PS)was 1, he underwent 4 courses of nab-paclitaxel(nab-PTX)plus carboplatin(CBDCA)plus pembrolizumab chemotherapy and pembrolizumab maintenance chemotherapy. The stenosis of the right main bronchus was clear after chemotherapy, and his dyspnea was improved. Chemotherapy using nab-PTX plus CBDCA plus pembrolizumab may become one of the therapeutic choices for the recurrence after operation of an elderly person with squamous cell lung carcinoma and low PD-L1 expression.
要旨
症例は81歳,男性。呼吸困難にて当医療センターに入院した。5年前に右上葉扁平上皮肺癌にて右上葉切除術を施行されていた。胸部CTでは右主気管支の狭窄を認め,病理組織学的診断は扁平上皮癌であった。PD-L1発現はTPS 1%で低発現であった。患者はPS 1であったため,nab-PTX+CBDCA+pembrolizumab化学療法を4コース施行し,その後pembrolizumabによる維持療法を行った。化学療法後,右主気管支の狭窄は消失し,呼吸困難も改善した。nab-PTX+CBDCA+pembrolizumab化学療法は,PD-L1低発現である高齢者扁平上皮肺癌術後再発に対して治療方法の選択肢の一つとなる可能性がある。