PMC10176449_01
(A) The PET-CT showed the high SUVmean of ascending colon and enlarged lymph nodes of retroperitoneal and peritoneal. (B) In a PRaG cycle, radiotherapy was delivered for metastases, followed by GM-CSF subcutaneous (sc) injection once daily for two weeks, and toripalimab was intravenous(iv) once within one week after radiotherapy. PRaG Therapy was repeated every three weeks, and three cycles of triple-therapy were administered. Subsequently, the patient underwent three cycles of PD-1 inhibotor and GM-CSF maintenance treatment.
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PRaG cycle, radiotherapy (8Gy or 5Gy/d, d1-3) was delivered for lymph node metastases, followed by subcutaneous injection of GM-CSF (200mug once daily, d4-17) and intravenous injection of toripalimab (240mg, d4). PRaG regimen was repeated every three weeks ( Figure 1B ).
PMC10176449_02
PMC10176449_03
(A) The PET-CT showed the high SUVmean of ascending colon and enlarged lymph nodes of retroperitoneal and peritoneal. (B) In a PRaG cycle, radiotherapy was delivered for metastases, followed by GM-CSF subcutaneous (sc) injection once daily for two weeks, and toripalimab was intravenous(iv) once within one week after radiotherapy. PRaG Therapy was repeated every three weeks, and three cycles of triple-therapy were administered. Subsequently, the patient underwent three cycles of PD-1 inhibotor and GM-CSF maintenance treatment.
fonc-13-1078915-g001.jpg
PMC10176449_03_fonc-13-1078915-g001.jpg
f1
PRaG cycle, radiotherapy (8Gy or 5Gy/d, d1-3) was delivered for lymph node metastases, followed by subcutaneous injection of GM-CSF (200mug once daily, d4-17) and intravenous injection of toripalimab (240mg, d4). PRaG regimen was repeated every three weeks ( Figure 1B ).
CT scans before, during, and after the PRaG therapy. The CT scans (A, B) showed shrunk and disappeared of irradiated lymph node metastases. The CT scans (C) showed shrunk and disappeared of nonirradiated lymph node metastases. The arrows point to individual lymph nodes, and the circles include fusion lymph nodes.
fonc-13-1078915-g002.jpg
PMC10176449_04_fonc-13-1078915-g002.jpg
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After the PRaG therapy, the CT scan showed that lymph node metastases in retroperitoneal and celiac almost disappeared compared with before ( Figure 2 ).
(A) The carcinoembryonic antigen (CEA) dropped to the normal range after two cycles of PRaG Therapy. In the whole course of treatment, the patients had no obvious adverse reactions. Due to the influence of COVID-19, the re-examination interval was longer than expected. (B) The scheme shows the complete treatment process of the patient. (C) The number and activation of lymphocytes are related to the efficacy of immunotherapy.
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The PFS has more than 2 years so far ( Figure 3B ).
PMC10176449_04
CT scans before, during, and after the PRaG therapy. The CT scans (A, B) showed shrunk and disappeared of irradiated lymph node metastases. The CT scans (C) showed shrunk and disappeared of nonirradiated lymph node metastases. The arrows point to individual lymph nodes, and the circles include fusion lymph nodes.
fonc-13-1078915-g002.jpg
PMC10176449_04_fonc-13-1078915-g002.jpg
f2
After the PRaG therapy, the CT scan showed that lymph node metastases in retroperitoneal and celiac almost disappeared compared with before ( Figure 2 ).
(A) The carcinoembryonic antigen (CEA) dropped to the normal range after two cycles of PRaG Therapy. In the whole course of treatment, the patients had no obvious adverse reactions. Due to the influence of COVID-19, the re-examination interval was longer than expected. (B) The scheme shows the complete treatment process of the patient. (C) The number and activation of lymphocytes are related to the efficacy of immunotherapy.
fonc-13-1078915-g003.jpg
PMC10176449_04_fonc-13-1078915-g003.jpg
f3
The PFS has more than 2 years so far ( Figure 3B ).