PMC7429217_01
Immunohistochemical result of prostate cancer. Immunohistochemical result of the initial biopsy before treatment showed moderately differentiated adenocarcinoma of the prostate (A) with Gleason score 8(4+4) and be positive for p504s (B) and CK5/6 (C) (original magnification X 200). Immunohistochemical result of the second biopsy after relapse showed small-cell carcinoma of the prostate (D) and be positive for chromogranin A (E) and synaptophysin (F) (original magnification X 200).
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The immunohistochemical result contained characteristics of neuroendocrine carcinoma, which was positive for synaptophysin (Figure 1).
Imaging material of prostate cancer. (A) Before radiotherapy combined with olaparib, computed tomography (CT) of the pelvis showed a primary prostate tumor, which invaded the bilateral seminal vesicle gland and closed to the rectum in December 2018. (B) The size of prostate tumor shrank significantly after radiotherapy combined with olaparib in January 2019. (C) Primary tumor remained stable after radiotherapy combined with olaparib in February 2019. (D) Before using olaparib, computed tomography (CT) of the pelvis showed enlarged lymph nodes adjacent to aorta abdominalis in December 2018, which was not included into the radiation field. (E) After using olaparib, lymph nodes adjacent to aorta abdominalis shrank significantly in January 2019, which was not included into the radiation field. (F) After 2.5 months with olaparib, lymph nodes adjacent to aorta abdominalis enlarged again in February 2019, which was not included into the radiation field.
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In contrast to the CT demonstration in December 2018, the pelvic enhanced CT in January 2019 showed a nearly complete tumor response in the radiation field and a partial tumor response in the region that was not covered in the radiation field (Figure 2), which verified the therapeutic effect of olaparib. Pelvic enhanced CT showed tumor progression (Figure 2) and with skull, sternum, bilateral upper humerus, bilateral scapula, multiple bilateral ribs, multiple spine, multiple pelvis, and bilateral femoral metastases.