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Vol.60 No.3 contents | Japanese/English |
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- Case Report -
A Case of Malignant Pleural Mesothelioma with Tumor Regression as an Abscopal Effect Induced by a Palliative Radiotherapy
Yuka Shiraishi1, Satoshi Hirano2, Takashi Aruga3, Tsuguko Kuroki1, Nami Hayama1, Tetsuo Fujita1, Hiroyuki Amano1, Makoto Nakamura1, Sukeyuki Nakamura1, Hiroshi Tabeta41Department of Respiratory Medicine, 2Department of Medical Oncology, 3Department of Radiation Oncology, 4Department of Palliative Care Internal Medicine, Funabashi Municipal Medical Center, Japan
Background. An abscopal effect refers to a rare phenomenon in radiotherapy characterized by tumor regression outside the irradiated volume. Abscopal effects in malignant pleural mesothelioma are extremely rare. Case. A 75-year-old man was treated with palliative radiotherapy for the purpose of pain relief after the postoperative recurrence of epithelial malignant pleural mesothelioma. Two months later, his pain was improved; however, CT showed an exacerbation of the non-irradiated lesions. His serum cytokeratin fragment (CYFRA 21-1) level (36.0 ng/ml) was elevated. Six months later, his serum CYFRA 21-1 level decreased to 5.5 ng/ml, and a marked reduction of the lesions outside of the irradiation field was observed. After palliative or whole-brain irradiation for subsequent recurrence and the administration of nivolumab, a PD-1 inhibitor, CT revealed partial tumor shrinkage and his serum CYFRA 21-1 level decreased 1 month later. Conclusion. It was suggested that the effect of an immune checkpoint inhibitor could be expected after radiotherapy in a patient with malignant pleural mesothelioma, or that the appearance of an abscopal effect could be a predictor of the effect of immune checkpoint inhibitor treatment.
key words: Malignant pleural mesothelioma, Abscopal effect, Nivolumab, Immune checkpoint inhibitor, Palliative radiotherapy
Received: December 26, 2019
Accepted: March 18, 2020
JJLC 60 (3): 187-191, 2020
