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After lung cancer surgery, how to achieve stable disease without progression for 3 years

时间:2026-04-22 人气:

If you cannot understand the subsequent professional description, you can finish reading this text in two minutes

Overview of the condition


 
In 2020, Ms. Chen underwent a physical examination and was found to have a right lung lesion. In May of the same year, she underwent a PET-CT scan: 1. A nodule in the upper lobe of the right lung with increased metabolism, suggesting lung cancer. 2. Ground-glass density nodules in both lungs without increased metabolism, the largest of which measured 0.8cm*0.7cm, with uncertain nature, and it was recommended to closely follow up with thin-layer CT to exclude early lung cancer. Small solid nodules in the lower lobes of both lungs without increased metabolism. After considering lung cancer, she immediately underwent "thoracoscopic lobectomy + mediastinal lymph node dissection" under general anesthesia.
Postoperative pathology: Lesion 1: Moderately-to-poorly differentiated adenocarcinoma, predominantly alveolar type (about 70%), with some solid (15%) and papillary (15%) patterns. Vascular tumor thrombus was visible, and microinvasive foci were observed in the adjacent lung tissue. The tumor had a maximum diameter of 1.5cm and did not invade the visceral pleura. No cancer was found at the bronchial resection margin.
Lesion 2: Highly-to-moderately differentiated adenocarcinoma with a diameter of 0.3cm, primarily primary in morphology, without involvement of the visceral pleura. No cancer was found at the resection margin, and no genetic testing was performed. The patient underwent four cycles of chemotherapy after surgery, with the chemotherapy regimen being pemetrexed plus carboplatin. Additionally, oral Chinese medicine was taken to further control the disease.
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Knowledge

Knowledge


 

Lung Cancer Gene Testing

The identification of a series of oncogenic driver genes in lung cancer has further refined the classification of lung cancer from a purely histopathological classification to a molecular classification based on driver genes. EGFR is commonly found in lung adenocarcinoma.

The EGFR gene is a type of gene that expresses epidermal growth factor receptors, promoting normal cell division and proliferation under physiological conditions. However, in some cases, mutations in proto-oncogenes can lead to the development of tumors, with a higher incidence in non-smoking female lung adenocarcinoma. When it was discovered that EGFR mutations often occur in lung adenocarcinoma tumors, people began to consider how to inhibit tumor growth by targeting these mutations. Later, EGFR monoclonal antibodies, commonly known as "targeted drugs," were developed. Typically, EGFR mutations make lung adenocarcinoma more sensitive to specific targeted drugs.

Ms. Chen underwent early-stage lung cancer surgery, but she remained uneasy. Through a friend's introduction, Ms. Chen and her family learned about Professor Zhang Minghui's NKT technology at Tsinghua University School of Medicine and carefully reviewed the displayed cases of NKT cell therapy, particularly hoping to try it to reduce the risk of tumor recurrence and delay the occurrence of recurrence and metastasis.

After reviewing Ms. Chen's medical records, Professor Zhang Minghui made the following analysis and judgment:

1. The patient was diagnosed with early-stage lung cancer through a physical examination and underwent radical surgery. The postoperative staging was early. However, the patient has multiple nodules in the lungs, with risk factors such as ground glass and solid small nodules, which cannot be taken lightly.

2. The patient has not undergone genetic testing, and it is recommended to undergo genetic testing to guide subsequent treatment based on the results.

3. NKT therapy uses powerful immune cells to kill tumor cells that may remain undetected in the body, and has minimal side effects. It can be combined with other treatment options such as targeted drugs.

Ms. Chen decided to use NKT cell immunotherapy in12 months, with an initial regimen of 1 course/month. By May 2022, a total of 22 courses of continuous systemic therapy were administered, during which multiple follow-up examinations did not show any significant signs of progression.

 

Image Aspects

Tumor markers

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From February 2021 to February 2023, the tests for CYFRA21-1, NSE, SCC, and CEA were all within the normal range.


 

 Conclusion and Comments

Ms. Chen's quality of life has been greatly improved. Her mental state is excellent, and she feels more energetic and vigorous when doing things than before.

Ms. Chen achieved the expected results after undergoing NKT cell therapy. After a long-term follow-up, there was no recurrence or metastasis of the primary tumor, and the pulmonary nodules remained stable without signs of canceration. Additionally, her quality of life improved.

Based on tumor volume, patients with stage Ia lung cancer are categorized into three groups: tumor volume ≤3cm³, 3-8c, and >8c. The five-year disease-free survival (DFS) rates for these groups are 88.0%, 73.6%, and 62.1%, respectively. This indicates that tumor volume is an independent risk factor for DFS and overall survival (OS) in stage I non-small cell lung cancer (NSCLC) after complete tumor resection.

Although Ms. Chen underwent surgery for stage I lung cancer, she still couldn't be complacent. To achieve long-term stability, she opted for NKT cell therapy and achieved the desired results. In this process, NKT cell immunotherapy played an indispensable role in reducing the risk of recurrence and metastasis, while strengthening the immune system, thereby ensuring long-term stability for patients.

This information is for general knowledge purposes only and should not replace professional medical advice. Individual patients should consult with their healthcare providers.   

Reference:< H362>

【1】Department of Thoracic Surgery, Sun Yat Sen University Cancer Center, China; State Key Laboratory of Oncology in Southern China and Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Lung Cancer Institute, Sun Yat Sen University, Guangzhou, China.

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