医学
低温消融
免疫疗法
腺癌
养生
冷冻外科
吞咽困难
内科学
恶性肿瘤
癌症
肿瘤科
外科
烧蚀
作者
Benjamin Norton,Apostolis Papaefthymiou,Andrea Telese,Margaret Duku,Imran B. Chaudhry,Alberto Murino,Gavin Johnson,Charles Murray,Rehan Haidry
出处
期刊:Frontline Gastroenterology
[BMJ]
日期:2024-03-15
卷期号:15 (4): 336-339
标识
DOI:10.1136/flgastro-2024-102666
摘要
Metastatic oesophageal adenocarcinoma (OAC) is associated with a poor prognosis, but patients with a good performance status may be offered palliative oncological intervention. Oesophageal cryoablation is an emerging therapy for the palliation of malignant dysphagia that can be given over multiple sessions with relatively few side effects. Emerging evidence suggests that cryoablation may provide a synergistic effect with modern immunotherapies as cryonecrosis leads to the release of many tumour-specific autoantigens that induce a systemic antitumour response. We present the case of a 39-year-old man who presented with several months of non-specific upper abdominal pain and heartburn. He was subsequently diagnosed with metastatic OAC and proceeded to self-funded genomic tumour profiling. This enabled initiation of a personalised oncological treatment plan involving immunotherapy and a neoantigen cancer vaccination regimen. To facilitate continued oral intake and avoid the risk of endoscopic stenting, the patient underwent a concurrent programme of oesophageal balloon cryoablation over eight sessions. At 15 months following his diagnosis, he had complete histological remission of luminal disease and a preserved systemic treatment response. In summary, oesophageal cryoablation is an endoscopic option for luminal control among patients undergoing immunotherapy for metastatic OAC. This would provide a synergistic treatment effect and mitigate against the risk of endoscopic stenting.
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