Characteristics of small cell lung cancer?
Smoking is the most important risk factor for small cell lung cancer. This kind of cancer often occurs in the mediastinum, which is easy to compress the trachea, so patients often feel very short of breath, which seriously affects their quality of life. Guo, an attending physician in the thoracic department of Keelung Chang Gung Hospital, said that due to the rapid growth, 80% of patients with small cell lung cancer were terminally ill when they arrived at the hospital, and there was no major breakthrough in treatment choice in the past. First-line chemotherapy usually failed after 5 months, and cancer cells would grow again within 3 months after chemotherapy treatment. Even with second-line chemotherapy, the treatment effect is not good, and it is almost regarded as a terminal disease. So although small cell lung cancer only accounts for 65438+ of all lung cancers.
Treatment options for small cell lung cancer?
Dr. Guo said that although chemotherapy was the only treatment option in the past, if the patient was unfortunately diagnosed, the doctor would still advise the patient to use first-line chemotherapy, because the side effects were not great, and the probability of tumor shrinkage could reach more than 60%, which could at least help the patient and his family win more time and maintain a good quality of life. Fortunately, due to the progress of medical science and technology, there is now the choice of immunotherapy in treatment. If chemotherapy and immunotherapy can be used at the same time, the survival time can be extended to more than 12 months, and some patients will continue to be effective, which is a good phenomenon that has never appeared in previous treatments. Although the probability of maintaining cancer recurrence may be only 10-20% (so-called plateau effect or long tail effect), for any patient with this disease, if he happens to be a group with effective treatment,
Which patients recommend combination immunotherapy?
Dr. Guo mentioned that all patients can use it, because at present, it is impossible to predict the effect of immunotherapy through gene or receptor testing, and only when you really fight can you know whether it is effective. At first, it can be used with chemotherapy, and after chemotherapy, immunotherapy will continue, unless the tumor becomes bigger or has serious side effects. At present, it is found that the incidence of side effects of immunotherapy is similar to that of chemotherapy alone.
Some clinical patients with small cell lung cancer responded well to immunotherapy.
Dr. Guo pointed out that some patients with small cell lung cancer have responded well after immunotherapy, even better than non-small cell lung cancer. For these patients, there are virtually no other treatment options. Fortunately, the treatment result is not disappointing.
There is a 7 1 year-old smoking woman in the outpatient department who suffers from hypertension and chronic obstructive pulmonary disease. At the end of 20 17, she had an X-ray examination in the clinic. At that time, her lungs were normal, but the patient coughed for a long time because of careless medication, and she went to see a doctor again in March of the following year. A tumor of about 6 cm appeared in her left lung and was diagnosed as stage IV small cell lung cancer. After first-line chemotherapy, the tumor disappeared. However, there are great side effects. Considering that the side effects of other chemotherapy drugs will be greater, and there is no other life-saving method for small cell lung cancer, she is boldly advised to receive immunotherapy. From 2065438+July 2009, the patient's tumor was out of sight.
Another 5 1 year-old male went to the outpatient clinic at the beginning of 20 19, and found that the left lung tumor had compressed the bronchus and was diagnosed as stage 3B of small cell lung cancer. If it is discovered later, it may be four periods. After electrotherapy combined with chemotherapy, the effect is good. In the past, this gentleman had to wait for recurrence in the first-line treatment, but because of commercial insurance, it is recommended that the patient continue immunotherapy. 10 months later, the tumor disappeared. Especially after immunotherapy, the tumor disappeared completely and the treatment effect was quite good. At present, patients continue to receive immunotherapy.
Dr. Guo said that small cell lung cancer has a high degree of malignancy and few treatment options, but more and more evidence shows that chemotherapy combined with immunotherapy is effective. Because the number of patients is small, if medical insurance is open to payment, it should not increase the budget too much. It is suggested that the health insurance department should take this therapy into consideration and give patients a chance to live.
Subject: immunotherapy, chemotherapy, small cell lung cancer, lung cancer