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

  • Published online on: July 6, 2023     https://doi.org/10.3892/ol.2023.13947
  • Article Number: 361
  • Copyright: © Ji et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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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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August-2023
Volume 26 Issue 2

Print ISSN: 1792-1074
Online ISSN:1792-1082

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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