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Unexpected tumor response to palliative pelvic radiotherapy in mismatch repair-deficient advanced prostate cancer: a case report.
- Source :
-
Journal of Medical Case Reports . 12/7/2020, Vol. 14 Issue 1, p1-6. 6p. - Publication Year :
- 2020
-
Abstract
- <bold>Background: </bold>Mismatch-repair-deficiency resulting in microsatellite instability (MSI) may confer increased radiosensitivity in locally advanced/metastatic tumors and thus radiotherapy (RT) potentially might have a changing role in treating this subset of patients, alone or in combination with checkpoint inhibitors.<bold>Case Presentation: </bold>We report a 76 year-old Italian male patient presenting with locally advanced undifferentiated prostate cancer (LAPC), infiltrating bladder and rectum. Molecular analysis revealed high-MSI with an altered expression of MSH2 and MSH6 at immunohistochemistry. Two months after 6 chemotherapy cycles with Docetaxel associated to an LHRH analogue, a computed tomography scan showed stable disease. After palliative RT (30 Gy/10 fractions) directed to the tumor mass with a 3D-conformal setup, a follow-up computed tomography scan at 8 weeks revealed an impressive response that remained stable at computed tomography after 9 months, with sustained biochemical response. To our knowledge, this is the first case of such a sustained response to low dose RT alone in high-MSI LAPC.<bold>Conclusions: </bold>Routine evaluation of MSI in patients with locally problematic advanced tumors might change treatment strategy and treatment aim in this setting, from a purely palliative approach to a quasi-curative paradigm. [ABSTRACT FROM AUTHOR]
- Subjects :
- *MICROSATELLITE repeats
*RADIOTHERAPY
*TUMORS
*IMMUNOHISTOCHEMISTRY
*YEAR
Subjects
Details
- Language :
- English
- ISSN :
- 17521947
- Volume :
- 14
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Medical Case Reports
- Publication Type :
- Academic Journal
- Accession number :
- 147455077
- Full Text :
- https://doi.org/10.1186/s13256-020-02578-4