PMC6927257_01
Post-contrast brain MR Imaging of the head before and after treatment. In November 2015, the patient was found to have lung cancer with brain (left, 4.4x3.1 cm) and cerebellar (right, 4.0x3.1 cm) metastasis. After resection and targeted drug therapy, there was no recurrence of metastases after 19 months. Solid arrow = brain metastasis; hollow arrow = cerebellar metastasis.
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The intracranial and lung tumors were controlled well until June 2017 (Figure 1).
Post-contrast brain MRI of the head before and after hydrogen inhalation. (A) In April 2018, the patient was found to have multiple metastases (white arrows) in the brain (left, 2.5x3.0 cm and 2.4x2.8 cm for two bigger tumors) and cerebellum (right, 1.3x1.8 cm and 1.2x0.7 cm for two bigger tumors). Also, the third ventricle and lateral ventricles were expanded and had accumulated hydrocephalus. (B) After 4 months of hydrogen inhalation, all tumors visible to the naked eye had disappeared, and the shape of ventricles had returned to normal. (C) After 1 year of inhalation (April 2019), recurrence had not occurred.
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Enhanced MR imaging of the head revealed multiple nodular metastases in the left cranial cavity; the third ventricle and lateral ventricles accumulated hydrocephalus, and the largest lesion was in the frontal lobe (1.9 x 1.4 cm) (Figure 2A). After 4 months, most brain metastases disappeared and the amount of hydrocephalus in the third ventricle and lateral ventricles were both reduced (Figure 2B). After 1 year, all visible brain tumors had disappeared, and there were no obvious changes in metastases in the liver and lung (Figure 2C).
Detection of serum tumor markers before and after hydrogen inhalation. The red line and the lower area in each figure represent the normal range.. Abbreviations: CEA, carcinoembryonic antigen; CA125, carbohydrate antigen 125; CYFRA21-1, cytokeratin fragment antigen 21-1.
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Serum levels of these three markers continued to decrease after 4 months of treatment (21.6 ng/mL, 83 U/mL and 8.5 ng/mL, respectively), and were close to (but remained above) the reference range after 1 year of treatment (12.3 ng/mL, 61 U/mL and 5.9 ng/mL, respectively) (Figure 3).