Individualized Treatment and Palliative Care for A 90-Year-Old Patient with Primary Gastric Diffuse Large-B Cell Lymphoma: 4 Year Follow-up and Inspiration.

Author: Yan Jie CAO ¹ ; Jingqi DUAN ¹ ; Li Fang LIU ¹ ; Xuan WEI ¹ ; Li REN ² ; Lan Ning ZHANG ¹ ; Wei ZHANG ¹
Author Information

1. Department of Geriatrics,Air Force Medical Center, Beijing 100142, China.
2. Department of Pathology, Air Force Medical Center, Beijing 100142, China.
Publication Type:Journal Article
From: Chinese Medical Sciences Journal 2021;36(1):72-77
CountryChina
Language:English
Abstract: A 90-year-old man was diagnosed with primary gastric diffuse large B-cell lymphoma (PGDLBL) by PET/CT examination, gastroscopy, biopsy and histopathological analysis at a regular physical check in April, 2016. The patient received R-CO chemotherapy (rituximab, cyclophosphamide, and vincristine) and radiotherapy subsequently, with enteral nutritional treatment through 3-cavity nasogastric tube due to development of pyloric obstruction. To satisfy patient's strong desire of eating by himself, we performed surgery of exploratory laparotomy and Roux-en-Y gastric bypass (RGB) to relieve pylorus obstruction. Postoperatively, the patient resumed oral feeding, supplemented by nasogastric tube feeding at 1350 - 1550 Kcal daily. He is now 94 years old with fairly well nutrition and normal communication. The outcome of 4 year follow-up suggests that nutritional treatment and palliative medicine are important for improving prognosis and life-quality of very elderly patients with end-stage tumors apart from the effective chemotherapy, radiotherapy, and surgery.