EXON 19 DELESYONU SAPTANAN SKUAMOZ H�CREL� AKC��ER KARS�NOMU�NDA AFAT�N�B TEDAV�S�: OLGU SUNUMU

K�M�RC�O�LU, Berna; YILDIRIM, Eylem; G�RSOY, P�nar; NART, Deniz; AKYOL, Murat

Cilt : 33 Ek : 1 Y�l : 2023

37/3Son Say� Erken Bask� Ar�iv Pop�ler Makaleler

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EXON 19 DELESYONU SAPTANAN SKUAMOZ H�CREL� AKC��ER KARS�NOMU�NDA AFAT�N�B TEDAV�S�: OLGU SUNUMU [G��s Hastanesi Dergisi]

G��s Hastanesi Dergisi. 2019; 33(1): 47-50

EXON 19 DELESYONU SAPTANAN SKUAMOZ H�CREL� AKC��ER KARS�NOMU�NDA AFAT�N�B TEDAV�S�: OLGU SUNUMU

Berna K�M�RC�O�LU¹, Eylem YILDIRIM¹, P�nar G�RSOY², Deniz NART³, Murat AKYOL⁴
¹SB� �zmir Dr. Suat Seren G��s Hastal�klar� ve Cerrahisi SUAM, G��s Hastal�klar� Klini�i, �zmir, T�rkiye
²Ege �niversitesi T�p Fak�ltesi, T�bbi Onkoloji Bilim Dal�, �zmir, T�rkiye
³Ege �niversitesi T�p Fak�ltesi, Patoloji Anabilim Dal�, �zmir, T�rkiye
⁴SB� �zmir Dr. Suat Seren G��s Hastal�klar� ve Cerrahisi SUAM, T�bbi Onkoloji Klini�i, �zmir, T�rkiye

Altm�� alt� ya��nda sigara i�me �yk�s� olan erkek hasta �ks�r�k, halsizlik, kilo kayb� ve kol a�r�s� yak�nmalar�yla ba�vurdu. Hastan�n �ekilen akci�er grafisinde sol alt zonda homojen dansite art�m� izlendi. Toraks bilgisayarl� tomografide sol alt lobda lob�le konturlu kitlesel lezyon saptand�. Endobron�ial biyopsi ve transbron�ial i�ne aspirasyon biyopsi ile skuamoz h�creli akci�er karsinomu tan�s� ald�. Evrelemede beyin, kemik ve karaci�er metastaz� saptand�. Hasta evre 4 skuamoz h�creli akci�er karsinomu- multipl uzak metastaz alan� M1b olarak evrelendi. Beyin metastaz� i�in kranial radyoterapi planland�. Hasta �nerilen sistemik kemoterapiyi kabul etmedi. Patolojik preparatlar�n genetik analizlerinde exon 19 delesyonu pozitif saptanmas� �zerine afatinib tedavisine ba�land�. Tedavinin 3. ve 6. ay�ndaki de�erlendirmede, hastan�n primer kitlesi ve beyin metastaz�nda bariz regresyon izlendi. Hastada aral�kl� ba� d�nmesi ve halsizlik yak�nmas� d��nda ciddi herhangi bir ila� yan etkisi izlenmedi�i g�r�ld�. Ancak tedavinin 8. ay�nda ba� a�r�s� ve ani bilin� kayb� geli�en hastan�n eksitus oldu�u ��renildi.

Anahtar Kelimeler: Afatinib, akci�er kanseri, EGFR, skuamoz h�creli karsinom

AFATINIB TREATMENT IN SQUAMOUS CELL LUNG CARCINOMA WITH EXON 19 DELETION: CASE REPORT

A 66-year-old male with a history of smoking was admitted with the symptoms of cough, malaise, weight loss and arm pain. The patient's chest radiography showed a homogeneous density in the left lower zone. Thoracic computed tomography revealed a mass lesion with a lobulated contour in the left lower lobe. Endobronchial biopsy and transbronchial needle aspiration biopsy were reported as squamous cell lung carcinoma. Brain, bone and liver metastases were detected in the staging. Patient was staged as stage 4 squamous cell lung carcinoma- multiple distant metastasis sites M1b. Cranial radiotherapy was planned for brain metastasis. The patient did not accept the systemic chemotherapy. As genetic analysis of pathological preparations showed that exon 19 deletion was positive, the patient was initiated on afatinib treatment. In the 3rd and 6th months of the treatment, the patient's primary mass and brain metastasis were markedly regressed. The patient did not have any serious side effects except intermittent dizziness and fatigue. However, he died of sudden loss of consciousness in the 8th month of the treatment.

Keywords: Afatinib, EGFR, lung cancer, squamous cell lung carcinoma

Makale Dili: T�rk�e

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