放射線治療後にアブスコパル効果現出が示唆された両側性多発肺癌の1例

A case of bilateral multiple lung cancers suggestive of an abscopal effect following radiotherapy

放射線治療によって標的腫瘍だけでなく，照射野外の離れた腫瘍にも抗腫瘍効果が現れるまれな現象をアブスコパル効果という^1）。今回我々は，多発肺癌の1病巣に放射線治療を行った結果，他病変が消失し，アブスコパル効果が現出したと思われる貴重な1例を経験した。放射線治療単独でのアブスコパル効果の報告はまれであり，文献的考察を加えて報告する。

We report a rare case of bilateral multiple lung cancer in which the abscopal effect was observed. The patient was an octogenarian male who was not a candidate for surgery. Stereotactic radiotherapy（66 Gy/11 fractions）was initially administered to the left lung lesion. Ten months later, regression of the contralateral pulmonary lesion was observed. One year after radiotherapy, hilar lymph node metastasis developed, and treatment with an immune checkpoint inhibitor was initiated. At 3 years and 9 months after radiotherapy, and 2 years and 11 months after the onset of the abscopal effect, the patient remains free of tumor progression or new recurrence.