除痰散结方联合安罗替尼延长腹膜后去分化脂肪肉瘤患者生存期1例
A Case of the Combination of Antitan Sanjie Prescription and Antipatinib to Prolong the Survival of Retroperitoneal Dedifferentiated Liposarcoma
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1.广州中医药大学第一附属医院肿瘤中心,广州 510405
2.广州中医药大学第一临床医学院,广州 510405
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余玲, 林瑞婷, 陈汉锐, 等. 除痰散结方联合安罗替尼延长腹膜后去分化脂肪肉瘤患者生存期1例[DB/OL].(2023-08-02)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=40358306&Fpath=home&index=0
YU Ling, LIN Ruiting, CHEN Hanrui, et al. A Case of the Combination of Antitan Sanjie Prescription and Antipatinib to Prolong the Survival of Retroperitoneal Dedifferentiated Liposarcoma[DB/OL].(2023-08-02)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=40358306&Fpath=home&index=0
余玲, 林瑞婷, 陈汉锐, 等. 除痰散结方联合安罗替尼延长腹膜后去分化脂肪肉瘤患者生存期1例[DB/OL].(2023-08-02)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=40358306&Fpath=home&index=0 DOI:
YU Ling, LIN Ruiting, CHEN Hanrui, et al. A Case of the Combination of Antitan Sanjie Prescription and Antipatinib to Prolong the Survival of Retroperitoneal Dedifferentiated Liposarcoma[DB/OL].(2023-08-02)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=40358306&Fpath=home&index=0 DOI:
病史摘要,2,患者中年女性,因“右腹膜后肿瘤切除术后复发二次术后10月”就诊。2016年11月患者行后腹膜去分化脂肪肉瘤切除术。2017年10月行二次复发手术。2018年1月CT未见复发,肝胃间隙结节不排转移。2018年8月林丽珠教授门诊就诊,四诊:疲乏,右侧胁肋游走性疼痛明显,时为针扎样疼痛,时为隐痛,偶口干,咽中有痰,恶心欲呕,纳眠差,二便调。舌淡苔白腻,脉滑。治法:健脾化痰,软坚散结,予自拟除痰散结方加减2年,联合安罗替尼19个月,右中下腹膜后复发肿瘤缓慢增大。2020年9月行腹膜后肿瘤切除+右肾切除+右肾上腺切除+右半结肠切除+膈肌修补术,术后中医药治疗。患者三次复发术后纯中医治疗,无病生存期达22个月,截止2022年7月患者仍随访中,OS长达5年8个月。中医诊断 肉瘤 痰湿凝聚证西医诊断 右腹膜后去分化脂肪肉瘤术后复发IV期。干预措施 患者发病及二次复发行后腹膜去分化脂肪肉瘤切除术,术后予自拟除痰散结方联合安罗替尼靶向治疗,三次复发再予手术切除后纯中医药治疗。疗效转归 患者首次术后9月复发,二次术后10月复发,经中医药联合安罗替尼靶向治疗,获19个月带瘤生存期,第三次术后获22个月无病生存期,目前随访未见复发转移,总生存期已达5年8个月,远超文献报道的8~13个月。
A middle-aged female patient presented to us with "recurrence of a right retroperitoneal tumor after resection 10 months after the second operation". In November 2016, the patient underwent retroperitoneal dedifferentiated liposarcoma resection. The second recurrence surgery was performed in October 2017. In January 2018, CT showed no recurrence, and no metastasis was found in the hepatic and gastric space nodules. In August 2018, Professor Lin Lizhu visited the outpatient clinic. She had four diagnoses: fatigue, obvious right flank migratory pain, sometimes needle-like pain, sometimes dull pain, occasionally dry mouth, phlegm in the pharynx, nausea and vomiting, poor sleep, and second constipation. Tongue pale moss white greasy, pulse slippery. Treatment: invigorating spleen and removing phlegm, soft and firm dispersing knots, adding or subtracting self-designed removing phlegm and dispersing knots for 2 years, combined with anlotinib for 19 months, the recurrence of right middle and lower retroperitoneal tumor slowly increased. In September 2020, "retroperitoneal tumor resection + right kidney resection + right adrenal resection + right hemicolectomy + diaphragmatic repair" was performed, and postoperative traditional Chinese medicine treatment was performed. The patient was treated with pure traditional Chinese medicine after three recurrence operations, and the disease-free survival time was 22 months. By July 2022, the patient was still followed up, and the OS was as long as 5 years and 8 months,TCM diagnosis, TCM diagnosis of sarcoma phlegm wet condensation syndrome;,Western medicine diagnosis, postoperative recurrence of right retroperitoneal dedifferentiated liposarcoma stage IV.,Therapeutic methods, The patients were treated with self-designed Jietan Sanjie prescription combined with anlotinib after the operation. The patients were treated with pure traditional Chinese medicine after surgical resection after three recurrence.,Clinical outcomes, The patient relapsed 9 months after the first operation and 10 months after the second operation. After targeted therapy with traditional Chinese medicine combined with anlotinib, the patient achieved 19 months of tumor-carrying survival, and 22 months of disease-free survival after the third operation. No recurrence or metastasis was found in the current follow-up, and the overall survival has reached 5 years and 8 months, far longer than 8-13 months reported in the literature.
去分化脂肪肉瘤中医药中西医结合治疗靶向治疗无进展生存期
dedifferentiated liposarcomaTraditional Chinese medicineintegrated Chinese and western medicine treatmenttargeted therapyprogression-free survival
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