错配修复缺陷直肠癌免疫治疗后的直肠狭窄。病例报告及文献复习

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical and Translational Radiation Oncology Pub Date : 2025-04-09 DOI:10.1016/j.ctro.2025.100953

Marcel Büttner , Ulrike Schempf , Robert Bachmann , Rüdiger Hoffmann , Christopher Schroeder , Sven Mattern , Stephan Singer , Marc Steinle , Maximilian Niyazi , Michael Bitzer , Cihan Gani

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引用次数: 0

摘要

我们报告一例57岁的男性患者，他在直肠中部表现为环状ct3cn1直肠腺癌。发现肿瘤错配修复缺陷/微卫星不稳定（dMMR/MSI）。采用多模式的放化疗免疫治疗取代了多模式的化疗。总的来说，治疗耐受性良好，内窥镜检查和MRI显示治疗反应的早期迹象。尽管如此，患者还是因瘢痕形成而出现肠梗阻，需要反复进行球囊扩张。与其他肿瘤治疗相比，dMMR直肠癌免疫治疗期间梗阻可能恶化。当患者在疾病后咨询最佳治疗方案时，必须考虑到这些信息。

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Rectal stenosis after immunotherapy in a mismatch repair deficient rectal cancer. Case report and review of literature

We report the case of a 57-year-old male patient who presented with a circumferential cT3 cN1 rectal adenocarcinoma in the mid rectum. The tumor was found to be mismatch repair deficient/microsatellite instable (dMMR/MSI). Instead of multimodality treatment with chemoradiotherapy immunotherapy with Dostarlimab was initiated. Treatment was well-tolerated in general and endoscopy and MRI showed early signs of treatment response. Despite this, the patient developed intestinal obstruction due to scarring that required repeat balloon dilations. In contrast to other oncological treatments, obstructions may worsen during immunotherapy in dMMR rectal cancers. This information has to be considered when patients are consulted regarding the optimal treatment after disease.

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