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Overview of the condition
Mr. Chen 2020.8 found the left eye choroidal mass through eye ultrasound, and found multiple liver mass through abdominal ultrasound, and confirmed by puncture biopsy as choroidal melanoma liver metastases. Metastases from the 4th lumbar spine, sacral bone, and left side of the hip bone were also found after PET/CT. Interventional therapy was implemented in the hepatic mass, followed by oral remvatinib-targeted therapy + sindilimab immunotherapy to date.
After the discovery of the primary lesion and metastases, Mr. Chen went to Tongren Hospital to perform radiotherapy for the eye choroid lesions (the specific plan is unknown), but because there had been systemic metastases and the degree of malignancy of melanoma was high, the doctors were not optimistic about Mr. Chen's condition at that time, and believed that Mr. Chen's survival time might not exceed 6 months.
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Choroidal melanoma:
Choroidal malignant melanoma is a common intraocular malignancy in adults, mostly occurring in adults aged 50 to 60 years, mainly originating from pigment cells in uveal tissue. Clinically, there are two ways of growth: (1) Limitation: It grows localized between the vitreous membrane of the sclera and choroidal membrane, showing a flat oval shape. Growth is slower due to the limitation of the sclera and the vitreous membrane. (2) Diffuse: characterized by extensive diffuse infiltration, tumor cells infiltration along blood vessels and lymphatic sheaths, and expansion along the choroidal plane, usually can occur extraocular and systemic metastases, malignancy is often relatively high.
In his prime, he was suddenly "sentenced to death" by the hospital, and the whole family was very anxious and anxious. It just so happened that a relative also had a late malignancy after using the NKT technology of Professor Zhang Minghui of Tsinghua University School of Medicine, the effect was very stable, and Mr. Chen's family decided to try it.
After receiving Mr. Chen's medical records, our team found that this patient, who had already undergone multiple metastases throughout the body, did not meet our criteria for entering the treatment. The treatment did not benefit much and he declined Mr. Chen, but his family's desire for treatment was very strong, even if it was to improve some quality of life.
After reading Mr. Chen's medical records, Professor Zhang Minghui made the following analysis and judgment:
1. The degree of malignancy of melanoma is high, and the prognosis is poor, but the patient is younger and has a strong desire for treatment.
2. The patient has found multiple metastases in the liver and bone at the beginning of the discovery, and has not undergone surgical treatment.
3. Choroidal melanoma is not sensitive to chemotherapy, for advanced patients who have multiple metastases, it is not recommended to surgically remove the eyeball, in the case that the traditional surgery + chemotherapy regimen cannot be carried out, it can be combined with radiation therapy + immunity to inhibit tumor progression, prolong the patient's life and improve the quality of life.
4. NKT treatment is the use of powerful immune cells to kill those tumor cells that remain in the body, because NKT treatment basically has no side effects and is very friendly to the patient's body, and can be combined with precision radiotherapy, targeted drugs and other combination therapy to inhibit tumor progression.
Mr. Chen was treated with NKT cell immunotherapy in August 2020 and has completed 30 courses of treatment for a total of 17 months (as of February 2022). In February 2021, after initiating NKT treatment, Mr. Chen underwent microwave ablation + TACE treatment for liver metastases. 2021.9 Gastric metastases were found through gastroscopy and surgical resection treatment, 2021.10 multiple metastases were found due to dizziness examination of brain magnetic resonance, and gamma knife radiotherapy was performed in 2021.12, while oral temozolomide was taken.
And now, nearly two years later, Mr. Chen broke the doctor's prediction that he would only have 6 months to survive!! Under the joint intervention of NKT and various programs such as surgery and radiotherapy after 30 courses of treatment, Mr. Chen's primary lesion and liver metastases were stable, and the new brain metastases lesions progressed, and the overall treatment was effective.
Imagery
In November 2020, the OC suggested a high signal in the lateral wall of the right eye, which was consistent with the manifestations of choroidal melanoma, and there was no significant change in the review in January and March 2022. In August 2021, PET-CT suggested that there were no obvious metastases in the right parietal and right temporal apical junctions, and multiple metabolic hypergraphia in the right frontotemporal occipital lobe, the total number of re-examined lesions in October 2021 was about 20, and the number of re-examined metastases in December 2021 increased significantly compared with October 2021, the larger ones were about 1 cm, the total number of metastases was about 28, and the total number of re-examined metastases in March 2022 increased from before, about 36. In December 2020, the density of some lesions in the liver was reduced and the scope was expanded, combined with the medical history, considering changes after treatment, and by March 2022, the size of some lesions was stable, and some lesions were not shown.
quality of life
Mr. Chen's quality of life after entering the treatment has been greatly improved, he is full of hope for life, and his energy in doing things feels more energetic than in the past. Currently living and working normally.
Conclusion
For the treatment of patients with advanced stage and multiple metastases is often more special and complex, it is difficult to achieve the desired effect through any single treatment plan, Mr. Chen's situation is exactly the case, the traditional conventional treatment has been unable to achieve better results, but in the NKT treatment combined with a variety of other programs to intervene, so that Mr. Chen's condition has been controlled, effectively inhibiting the speed of tumor progression, Mr. Chen's family is very pleased.
Popular science knowledge, for reference only, individual patients are subject to clinical treatment.
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