Long-Term Response To Pemetrexed Monotherapy In A Stop-To-Go Fashion In Progressive Bronchioloalveolar Carcinoma And Literature Review

Objective:Bronchioloalveolar carcinoma (BAC) was classified as a subtype of lung adenocarcinoma in the1999and2004WHO classifications. In recent years, the disease incidence may be rising. Its clinical manifestations are no specific and pathological diagnosis is controversial. Having various types of imaging changes and chemical treatment and efficacy has not been determined. Although in the2011new classification of lung adenocarcinoma,"BAC" is no longer used, suprior treatment experience is still useful for future study. This paper reports one case of single agent pemetrexed as maintenance and intermittent treatment of recurrence and metastasis postoperative bronchioloalveolar carcinoma for six years, combined with review of the literature, involving the definition, pathology, imaging, clinical manifestations and treatment, to help raise cognition of the disease.Methods:Report one case of single agent pemetrexed as maintenance therapy in patients with recurrence and metastasis of post-operative bronchioloalveolar carcinoma, while studied30patients with primary pulmonary bronchioloalveolar carcinoma adopted by China Academic Journal from2000to2014, analyzed the main clinical manifestations, imaging and diagnostic methods in order to reduce misdiagnosis, guide treatment and help estimate prognosis.Results:The patient underwent a total six years of3line pemetrexed monotherapy, PS score remained at0-1and could adhere to his daily work. Among30cases of primary pulmonary bronchioloalveolar carcinoma patients,17cases are male patients,13are female patients, the oldest is77years old and the youngest is35years old, with an average age of54.5years. The main clinical manifestations are cough, sputum, chest pain, irritating cough, etc. And the typical symptom, cough plenty of watery foamy sputum sample is very rare. Image changes are mainly nodularly and pneumonic type. The nodular lesions may show ground-glass characteristic changes. The diagnosis is easily confused with pneumonia, blood disseminated miliary tuberculosis and other types of lung cancers. Among30cases, only three cases reported chemotherapy and the survival is unknown.Conclusion:Treatment of certain bronchioloalveolar carcinoma with pemetrexed may be beneficial and safe; maintain and intermittent chemotherapy may be an effective treatment pattern for longer survival tumors.