20% and 65% of lung cancer patients will develop brain metastases during the course of the disease, which is the most common type of brain metastatic tumor. Mr. Su from Guizhou was diagnosed with brain metastasis of lung cancer and was sent to our hospital by his family**. Thanks to the efforts of our medical staff, Mr. Su has been able to live and work normally.
The incidence of brain metastasis of lung cancer is significantly higher than that of other tumors.
Mr. Su from Guizhou Province found a lung mass when he went to the hospital for a check-up three years ago because he had a cough and sputum. In February of this year, the biopsy results showed small cell lung cancer. Because he could not tolerate chemotherapy, Mr. Su gave up**, until recently, because of headache, he went to the hospital again for examination, but was told that lung cancer had brain metastases and lymphatic metastases.
On September 16, CT showed that Mr. Su's right frontal lobe and parietal lobe nodules were ring-shaped, with large surrounding edema, large edema in the right frontal lobe, and a right hilar mass (87cmx6.2cmx6.8cm）。The MR report diagnosed Mr. Su with multiple metastases in both sides of the brain, with a focus on the left parietal lobe, a large area of cerebral edema and brain herniation.
Professor Tang pointed out that brain metastasis is one of the common metastasis sites of cancer, and the incidence of brain metastasis in lung cancer is significantly higher than that of melanoma, breast cancer, kidney cancer and colorectal cancer. The risk of brain metastases from lung adenocarcinoma, squamous cell carcinoma, and large cell carcinoma is 12% and 12%, respectively.
The best principle of brain metastases in lung cancer
When he arrived at the hospital, Mr. Su was already in a coma, and his condition could worsen at any time, and even respiratory arrest, which was life-threatening. After fully communicating with the family, Professor Tang Rijie and the surgeons urgently arranged symptomatic treatment for the patient and actively discussed the best plan.
In principle, patients with brain metastases from lung cancer should be treated on a systemic basis. Considering that Mr. Su had a course of intolerance to traditional chemotherapy, combined with the current state of the patient, local arterial perfusion embolization combined with immunity was finally formulated**.
Under the guidance of DSA, Professor Tang Rijie performed minimally invasive surgery for Mr. Su**. The operation went very smoothly, and the doctor also arranged for Mr. Su to treat the symptoms such as immunization**, liver protection and stomach protection**.
In addition to the patient's intolerance, chemotherapy drugs are difficult to penetrate the blood-brain barrier to exert anti-tumor effects on intracranial metastases due to their large molecular weight, which is also the reason why we did not arrange chemotherapy for Mr. Su. Minimally invasive arterial perfusion embolization can directly deliver the drug to the tumor lesion through the catheter, reduce the damage to the surrounding normal tissues and organs, and can also reduce the risk of immunity, the current retrospective analysis of PD-1 and PD-L1 monoclonal antibody** lung cancer brain metastasis has shown certain efficacy.
Professor Tang Rijie pointed out that there are many programs for brain metastasis of lung cancer, and the reason why a comprehensive program of minimally invasive local tumor elimination + immune systemic surgery is arranged for patients is to metastasize lesions, improve patients' symptoms and quality of life, and do their best to prolong the survival time of patients.
Tumors should be treated not only for the disease, but also for the person.
Patients with brain metastases from lung cancer often have symptoms such as headache, nausea, and vomiting caused by increased intracranial pressure, which not only affect the quality of life of patients, but also affect the life safety of patients.
The clinical manifestations of parenchymal metastases mainly include headache, vomiting and diplopia, vision loss, dizziness, apathy, impaired consciousness, fecal incontinence, bradypulse, increased blood pressure, psychiatric symptoms, seizures, sensory impairment, movement disorders, aphasia, visual field impairment, etc.
Depending on where cancer cells invade the brain, the specific manifestations are complex and diverse, and often lack specificity. Therefore, Professor Tang Rijie can only suggest that if lung cancer patients have the above similar symptoms, it is recommended that patients do a cranial magnetic resonance imaging examination, which can help find medium and high abnormal signals.