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Case Report Open Access

Radionecrosis mimicking pseudo‑progression in a patient with lung cancer and brain metastasis following the combination of anti‑PD‑1 therapy and stereotactic radiosurgery: A case report

  • Authors:
    • Xiaolin Ji
    • Luxuan Wang
    • Yanli Tan
    • Yanhong Shang
    • Ran Huo
    • Chuan Fang
    • Chunhui Li
    • Lijian Zhang
  • View Affiliations / Copyright

    Affiliations: Department of Neurosurgery, Clinical Medicine College, Affiliated Hospital of Hebei University, Hebei University, Baoding, Hebei 071000, P.R. China, Department of Neurological Examination, Affiliated Hospital of Hebei University, Hebei University, Baoding, Hebei 071000, P.R. China, Department of Pathology, Affiliated Hospital of Hebei University, Hebei University, Baoding, Hebei 071000, P.R. China, Department of Oncology, Affiliated Hospital of Hebei University, Hebei University, Baoding, Hebei 071000, P.R. China
    Copyright: © Ji et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 361
    |
    Published online on: July 6, 2023
       https://doi.org/10.3892/ol.2023.13947
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Abstract

Brain metastases (BMs) usually develop in patients with non‑small cell lung cancer. In addition to systemic therapy, radiation therapy and surgery, anti‑programmed cell death‑ligand 1 (PD‑L1) therapy is another promising clinical anticancer treatment modality. However, the optimal timing and drug‑drug interactions of anti‑PD‑L1 therapy with other combined treatments remain to be elucidated. Treatment with anti‑PD‑L1 therapy is associated with an increased risk of radionecrosis (RN) regardless of tumor histology. The present study described a case of RN in a patient with lung adenocarcinoma and with BM who received anti‑PD‑L1 therapy. Before anti‑PD‑L1 treatment, the patient received whole brain radiotherapy. During durvalumab treatment, the intracranial metastases regressed. The progression of intracranial lesions 9 months later prompted a second‑line of therapy with PD‑L1 inhibitor durvalumab and stereotactic radiotherapy (SRT). Despite stereotactic irradiation, the lesions progressed further, leading to surgical resection. On examination, RN was detected, but there was no evidence of metastatic lung cancer. The aim of the present study was to present the longitudinal change in magnetic resonance imaging in RN following STR and anti‑PD‑L1 combined therapy. The atypical image of RN is conditionally important for making an accurate preoperative diagnosis.
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Copy and paste a formatted citation
Spandidos Publications style
Ji X, Wang L, Tan Y, Shang Y, Huo R, Fang C, Li C and Zhang L: Radionecrosis mimicking pseudo‑progression in a patient with lung cancer and brain metastasis following the combination of anti‑PD‑1 therapy and stereotactic radiosurgery: A case report. Oncol Lett 26: 361, 2023.
APA
Ji, X., Wang, L., Tan, Y., Shang, Y., Huo, R., Fang, C. ... Zhang, L. (2023). Radionecrosis mimicking pseudo‑progression in a patient with lung cancer and brain metastasis following the combination of anti‑PD‑1 therapy and stereotactic radiosurgery: A case report. Oncology Letters, 26, 361. https://doi.org/10.3892/ol.2023.13947
MLA
Ji, X., Wang, L., Tan, Y., Shang, Y., Huo, R., Fang, C., Li, C., Zhang, L."Radionecrosis mimicking pseudo‑progression in a patient with lung cancer and brain metastasis following the combination of anti‑PD‑1 therapy and stereotactic radiosurgery: A case report". Oncology Letters 26.2 (2023): 361.
Chicago
Ji, X., Wang, L., Tan, Y., Shang, Y., Huo, R., Fang, C., Li, C., Zhang, L."Radionecrosis mimicking pseudo‑progression in a patient with lung cancer and brain metastasis following the combination of anti‑PD‑1 therapy and stereotactic radiosurgery: A case report". Oncology Letters 26, no. 2 (2023): 361. https://doi.org/10.3892/ol.2023.13947
Copy and paste a formatted citation
x
Spandidos Publications style
Ji X, Wang L, Tan Y, Shang Y, Huo R, Fang C, Li C and Zhang L: Radionecrosis mimicking pseudo‑progression in a patient with lung cancer and brain metastasis following the combination of anti‑PD‑1 therapy and stereotactic radiosurgery: A case report. Oncol Lett 26: 361, 2023.
APA
Ji, X., Wang, L., Tan, Y., Shang, Y., Huo, R., Fang, C. ... Zhang, L. (2023). Radionecrosis mimicking pseudo‑progression in a patient with lung cancer and brain metastasis following the combination of anti‑PD‑1 therapy and stereotactic radiosurgery: A case report. Oncology Letters, 26, 361. https://doi.org/10.3892/ol.2023.13947
MLA
Ji, X., Wang, L., Tan, Y., Shang, Y., Huo, R., Fang, C., Li, C., Zhang, L."Radionecrosis mimicking pseudo‑progression in a patient with lung cancer and brain metastasis following the combination of anti‑PD‑1 therapy and stereotactic radiosurgery: A case report". Oncology Letters 26.2 (2023): 361.
Chicago
Ji, X., Wang, L., Tan, Y., Shang, Y., Huo, R., Fang, C., Li, C., Zhang, L."Radionecrosis mimicking pseudo‑progression in a patient with lung cancer and brain metastasis following the combination of anti‑PD‑1 therapy and stereotactic radiosurgery: A case report". Oncology Letters 26, no. 2 (2023): 361. https://doi.org/10.3892/ol.2023.13947
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