PMC10067748_01
CT scanning showing the chronological response of the patient after a cycle of treatments. (A) CT before radiation. (B) CT after ten days of radiation revealing lesions. (C) CT revealing an abscopal effect following the sequential immunotherapy performed.
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However, the patient's lower abdominal pain persisted and the efficacy assessment test suggested a further progression in October 2020 ( Figure 1A ). Surprisingly, ten days after the treatment, CT scan analysis revealed not only an enlargement of the radiotherapy lesion (40x50mm), but also of the mesenteric lymph node lesions which were not treated with RT (40x41 mm) ( Figure 1B ). After three months, the patient's lower abdominal pain disappeared and serum carcinoembryonic antigen (CEA) levels returned within normal ranges with a regression of two target lesions, including the one located in the mesenteric lymph node not treated with radiation ( Figure 1C ).
Selected axial slices representing a spatial dose-distribution using an intense and modulated radiation therapy strategy.
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A total radiation dose of 50Gy/25F was delivered to the PGTV ( Figure 2 ).
PET-CT showing the remission of all lesions following the treatment.
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In November 2022 positron emission tomography-computed tomography (PET-CT) showing the remission of all lesions following the treatment ( Figure 3 ).
Timeline of the treatment plan following the surgery. PD, progressive disease; m, months; PFS, progression free survive; DFS, disease-free survival; KPS, Karnofsky Performance Status (KPS) refer to the Karnofsky performance status during that period.
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The timeline of the treatment plan following the surgery and CEA levels during treatment are showed in  Figures 4 ,  5 .
Carcinoembryonic antigen (CEA) levels during treatment.
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The timeline of the treatment plan following the surgery and CEA levels during treatment are showed in  Figures 4 ,  5 .