PMC8411646_01
Chest computed tomography before and after treatment with anaplastic lymphoma kinase
tyrosine kinase inhibitors (ALK-TKIs). (a) Changes after right lower lung adenocarcinoma
surgery (arrow). (b) and (c) CT scan after 27 days of alectinib treatment showed
bilateral interstitial changes, presenting as diffuse ground-glass shadows. (d) After
corticosteroid treatment, the ground-glass shadows in both lungs disappeared. (e) One
month after the withdrawal of targeted drug therapy, the tumor recurred in the right
lower lung, presenting an enlarged tumor. (f) The tumor shrank after 6 weeks of
crizotinib treatment. G: Crizotinib was administered for 6 months, followed up and found
to be stable in the right lower lung with no ILD recurrence.
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PMC8411646_01_10.1177_2050313X211042991-fig1.jpg
fig1-2050313X211042991
T1cN2M1a (pleura), IVa period, ALK (IHC +), sp = 1." After being discharged, the patient was placed on oral alectinib therapy (150 mg twice a day) for postoperative treatment of AK + NSCLC of the right lower lobe. A chest computer tomography scan (CT) was performed (Figure 1(a)) after 27 days, as the patient complained of gradually worsening breathing difficulties. Chest CT examination showed diffuse ground-glass opacity in both lungs (Figure 1(b) and (c)). This was reduced to 40 mg/day for the next 7 days, after which the patient's symptoms gradually disappeared and the CT images gradually returned to their postoperative appearance (Figure 1(d)). CT revealed an enlarged right lower lung lesion (Figure 1(e)). Considering the lack of alternative therapies, the patient, although fully aware of the associated risk of ILD, agreed to try oral crizotinib. The dosage was then increased to 500 mg/day for 4 weeks, at which point a chest CT was performed indicating a reduction in the lung tumor with no recurrence of ILD (Figure 1(f)). At the most recent follow-up (6 months later), CT showed no further improvement (Figure 1(g)) and the patient experienced no change in exercise tolerance.