安罗替尼维持治疗IV期大细胞神经内分泌肺癌1例并文献复习

Anlotinib Maintenance Therapy for Stage IV Large Cell Neuroendocrine Lung Cancer: A Case Report and Literature Review

摘要: 大细胞神经内分泌肺癌是临床中极为罕见的一种肺癌类型，病理学分类为神经内分泌肿瘤，在肺癌中约占1%。大细胞神经内分泌肺癌在发现时多数已全身转移，其治疗方式包括化疗、放疗、手术治疗，但预后均较差。目前，抗血管靶向药物不断发展，但其治疗大细胞神经内分泌肺癌的报道很少。所以我们在此报道一例大细胞神经内分泌肺癌伴脑转移使用安罗替尼维持治疗的病例，并对大细胞神经内分泌癌的治疗进展进行综述。一名68岁男性患者，因头晕、视物不清、下肢疼痛行全身查体发现肿瘤全身转移，穿刺证实为肺大细胞神经内分泌癌，一线给予依托泊苷 + 铂双药化疗同时颅脑放疗，2周期治疗后复查进展，更换二线伊立替康 + 铂双药化疗5周期，2、4周期评估病灶稳定，化疗结束后给予患者安罗替尼口服维持治疗，患者无疾病进展生存期为7.1个月，总生存期为13.1个月。本病例为以后肺大细胞神经内分泌癌的治疗提供新的思路。

Abstract: Large cell neuroendocrine carcinoma of lung is an extremely rare type of lung cancer in clinical practice. It is pathologically classified as neuroendocrine tumor, accounting for about 1% of lung cancers. Most large cell neuroendocrine lung cancer has systemic metastasis when it is discovered, and its treatment includes chemotherapy, radiotherapy and surgery, but the prognosis is poor. At present, anti-vascular targeting drugs have been developed continuously, but there are few reports on their treatment of large cell neuroendocrine lung cancer. Therefore, we herein report a case of lung large cell neuroendocrine carcinoma with brain metastasis treated with anlotinib maintenance therapy, and review the treatment progress of large cell neuroendocrine carcinoma. A 68-year-old male patient, because of dizziness, unclear vision, lower limb pain do systemic physical examination found that cancer that has spread to the whole body, puncture proof of pulmonary large cell neuro-endocrine carcinoma, a line to etoposide plus cisplatin double chemotherapy medicine cerebral ra-diation at the same time, check after 2 cycles of treatment progress, replace the second line stand for kang + platinum double chemotherapy medicine 5 cycles, 2, 4 cycle stability assessment lesions. After chemotherapy, patients were given oral maintenance therapy with anlotinib, and progres-sion-free survival was 7.1 months and overall survival was 13.1 months. This case provides new ideas for the treatment of lung large cell neuroendocrine carcinoma.