Efekt kliniczny chemioterapii u chorego z drobnokomórkowym rakiem pluca z czteroletnim okresem prze?ycia. Opis przypadku

Abstract

Author(s): A Rolski, B Biernacka, P Krawczyk, M Hammouda, J Milanowski

Small cell lung carcinoma (SCLC) grows extremely rapidly, becoming extensive-stage disease (ED) at the time of diagnosis. SCLC has the most aggressive clinical course of any type of pulmonary tumour, with median survival from diagnosis of only 2 to 4 months. Median survival of 12 to 18 months and 5-year survivals of 5% with current forms of chemotherapy and radiotherapy have been reported. We presented here the case report of limited-stage (LD) SCLC patient with 3-years survival (4 years from begining of the diagnostic process). The patient received sequential chemotherapy and thoracic radiation therapy as well as second- and three-line chemotherapy. In our study, we pointed at shorter duration of remission after first-line treatment (10 months) than after second-line treatment (15 months). The second-line chemotherapy was applied after disease progression. We obsreved pleural effusion and metastases to lymph nodes and liver (ED SCLC). In both scheme of treatment we used cis-platine-based chemotherapy but instead of Etoposide we applied Vinorelbine. We noted progression after three-line chemotherapy using Cyclophosfamide, Adriamycin and Vincristine. One of the most important mechanism causing the chemotherapy failure is the presence of neoplasm cell resitance to cytostatic agents. This case report suggest the usefulness of molecular examination in qualification for chemotherapy in SCLC patients.

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