Muna Zvita 2007, Ms. 54, uyo akawedzera hemoptysis kwemwedzi miviri, akarasikirwa nehuremu, akarasikirwa nehavi, uye akarwadziwa nemabhonzo. A CT chifuva scan yakaratidza 9 cm x 5.8 cm x 7.2 cm "hombe, yakasungirirwa, yakasarudzika yakawanda" mumutsara wezasi wezasi wemapapu. Uye zvakare, imwe diki-senge lesion yakawanikwa mune yepamusoro kuruboshwe lobe.
Gare gare, biopsy yakasimbisa inopinda, zvine mwero kusiyanisa mapapu squamous cell carcinoma. A CT scan airatidza kubatanidzwa kwemhasuru dzemadziro echipfuva uye akange aita metastasized. Bonzo rake scan yaive isina kunaka (pasina metastases). Naizvozvo, akaonekwa aine T4N1M0-IIIb nhanho isiri-diki sero kenza yemapapu.
Mumwedzi ye3, Ms. M akabatwa ne paclitaxel (260 mg) uye carboplatin (415 mg) ye3 cycles. Izvi zvinoderedza tumarara kusvika 7cm x 6cm x 5cm. Gare gare, chemoradiotherapy yakaitwa mukuwirirana ne2 cycles ye cisplatin (50 mg) uye 60 Gy yemwaranzi.
Mwedzi miviri mushure mekupedzwa kwechemoradiotherapy, Ms. M vakaziva kuti pakanga paine kuyedzwa kwekiriniki kwemapapu. jekiseni regomarara uye ndafunga kugamuchira CIMAvax yekudzivirira mushure mekufunga nezvazvo.
80% yevanhu vakagamuchira cyclophosphamide kurapwa pamberi peCIMAvax jekiseni yakaratidza zvimwe zvinopesana neEGF chiitiko. Kubaya majekiseni kunzvimbo dzakawanda kunowedzera basa.
A preoperative CT scan yakaratidza 3 cm x 3 cm lesion muzasi lobe (Mufananidzo 1). Kuruboshwe kwepamusoro lobe maronda aive asingasviki 1 cm muhupamhi, uye localized pleural effusion yaive yechipiri kune radiotherapy.
Mushure memwedzi mitatu yeCIMAvax yekurapa kenza yemapapu yekurapa, bundu rakadzikira kusvika 3 cm x 2 cm
Pamwedzi mitanhatu yekurapwa, bundu rakanga radzikira kubva pahuwandu hwaro hwepakutanga ne6% kusvika 30 cm x 1.5 cm isati yadzikama. Panguva ino, kunyunyuta kwake kwakaramba kuchiderera, uye ma lymph node emunharaunda akave madiki.
Munguva yekutanga kupfura gumi neshanu, Mai M havana kuona chero mhedzisiro. Mukati memaminetsi ejekiseni regumi nenomwe, kurwadziwa kwechiuno kwake "kwakawedzera" uye kwaionekwa semushonga une chekuita nemushonga weGrade 16. Zviratidzo zvakadzikira mushure memaminitsi gumi ekurapwa ne17 mg yeklorpheniramine, 3 mg yehydrocortisone uye 10 mg ye tramadol.
Gare gare, akafunga kumisa kurapwa nechirwere cheCIMAvax. Chipfuva CT scan chakaitwa mwedzi mitatu mushure mekumisa kurapwa (mwedzi gumi nesere mushure mekutanga kurapwa kweCIMAvax). Mwedzi mitanhatu yapfuura kubva pakuvhenekwa kwake kwekupedzisira, uye pakanga pasina "shanduko yakakosha" mukukura kwemota (Mufananidzo 18), uye mamiriro ake akaramba akatsiga.
Pakupedzisira kwekutevera-mwedzi makumi maviri nemasere mushure mekumira kubaiwa nhomba-veFNM vevakadzi vaive mune hutano hwakanaka uye vakagwinya uye vakagadzikana. Chimiro chake cheECOG chakaramba chiri pa28 (zvakanakisa). Panguva ino, apona mwedzi makumi mana nemasere kubva paakaonekwa uye mamiriro ake anoramba akadzikama.
Ms. M Mushonga wemukenza wemapapu yakatenderwa kushambadzira muCuba muna 2008 kuitira kuchengetedza kurapwa kwechikamu IIIB-IV isiri-yekuvhiya yepamusoro isiri diki cell cancer cancer (NSCLC). Uku ndiko kunyoreswa kwekutanga kwejekiseni rekurapa muCuba uye kunyoresa kwekutanga kwejekiseni rekudzivirira gomarara remapapu munyika.
