Efficacy of Metabolically Supported Chemotherapy Combined with Ketogenic Diet, Hyperthermia, and Hyperbaric Oxygen Therapy for Stage IV Triple-Negative Breast Cancer 代谢支持的化疗消除三阴性乳腺癌 – 病例报告

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. 2017 Jul; 9(7): e1445.
Published online 2017 Jul 7. doi: 10.7759/cureus.1445
PMCID: PMC5589510
PMID: 28924531

Efficacy of Metabolically Supported Chemotherapy Combined with Ketogenic Diet, Hyperthermia, and Hyperbaric Oxygen Therapy for Stage IV Triple-Negative Breast Cancer

Monitoring Editor: Alexander Muacevic and John R Adler

Abstract

Triple-negative breast cancer (TNBC) is more aggressive and metastatic than other breast cancer types. Cytotoxic chemotherapy is presently the predominant systemic therapy for TNBC patients. This case report highlights the influence of metabolically supported chemotherapy (MSCT), ketogenic diet (KD), hyperthermia (HT), and hyperbaric oxygen therapy (HBOT) in an overweight 29-year-old woman with stage IV (T4N3M1) triple-negative invasive ductal carcinoma of the breast. The patient presented with an observable mass in her left breast detected during a physical examination in December 2015. Magnetic resonance imaging revealed a Breast Imaging Reporting and Data System Category 5 tumor and multiple lymphadenomegaly in the left axilla. A Tru-Cut biopsy led to the diagnosis of a triple-negative nuclear grade 2 invasive ductal carcinoma. The patient was admitted to ChemoThermia Oncology Center, Istanbul, Turkey in October 2016, and a whole body (18F)-fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography (PET-CT) scan revealed a 77 mm x 55 mm primary tumor in her left breast, multiple left pectoral and axillary lymph nodes, multiple widespread liver masses, and an upper left nodular abdominal lesion. The patient received a treatment protocol consisting of MSCT, KD, HT, and HBOT. A follow-up whole body 18F-FDG PET-CT scan in February 2017 showed a complete therapeutic response with no evidence of abnormal FDG uptake. The patient continued to receive this treatment protocol and in April 2017 underwent a mastectomy, which revealed a complete pathological response consistent with the response indicated by her PET-CT imaging. This single case study presents evidence of a complete clinical, radiological, and pathological response following a six-month treatment period using a combination of MSCT and a novel metabolic therapy in a patient with stage IV TNBC.

2017年7月7日在Cureus发表的病例报告显示,包括代谢支持的化学疗法 (Metabolically supported chemotherapy),生酮饮食 (ketogenic diet),高热 (hyperthermia) 和高压氧治疗 (hyperbaric oxygen therapy) 的组合疗法成功治疗了IV期三阴性乳腺癌 (Stage IV triple negative breast cancer),并在六个月内杀死了可检测的癌细胞。

病情

根据本病例报告,一位二十九岁的超重女子在2015年12月在左乳房感到一肿块后去看医生。 肿块在2016年8月扩大。如磁共振图像所示,患者左乳腺癌肿块长到7.5厘米×7.5厘米×6.5厘米。 左腋窝也发现多发性淋巴结肿大。 此时,Tru-Cut活检将该疾病确认为核2级侵袭性ER-,PgR-和HER2-导管三阴性乳腺癌 (invasive ductal carcinoma of the breast)。

2016年10月,患者入院接受化疗治疗。 在治疗前,全身(18F) – 氟脱氧葡萄糖(FDG) – 正电子发射断层扫描计算机断层扫描(PET-CT)扫描显示左乳房有一7.7cm×5.5cm的肿瘤,和多个左胸部和腋窝淋巴结,多个质量 肝脏和左上结节性腹部的病变。 此时,她被诊断患有IV期(T4N3M1)三阴性侵入性奶管道三阴性乳腺癌。

患者接受组合治疗,包括代谢支持化疗,生酮饮食,高热和高压氧疗。 而在2017年2月,随访全身18F-FDG PET-CT扫描已经没有FDG摄取的任何异常迹象,这意味着在这时后,三阴性乳腺癌细胞已经消失。

为了防止意外,病人继续接受相同的治疗方案,直到2017年4月为止。那时,她进行了乳房切除术去除她的左乳房。 在2016年10月至2017年4月的这六个月的治疗后,所有临床,放射学和病理学证据表明,患者已经达到了理想的治疗结果,摆脱了IV期三阴性乳腺癌。

关于三阴性乳腺癌和治疗的一些背景

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