Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2021; 9(22): 6538-6543
Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6538
Bystander effect and abscopal effect in recurrent thymic carcinoma treated with carbon-ion radiation therapy: A case report
Yan-Shan Zhang, Yi-He Zhang, Xiao-Jun Li, Ting-Chao Hu, Wei-Zuo Chen, Xin Pan, Hong-Yu Chai, Yan-Cheng Ye
Yan-Shan Zhang, Yi-He Zhang, Xiao-Jun Li, Ting-Chao Hu, Wei-Zuo Chen, Xin Pan, Hong-Yu Chai, Yan-Cheng Ye, Department of Heavy Ion Center, Wuwei Cancer Hospital, Wuwei 733000, Gansu Province, China
Author contributions: Zhang YS and Zhang YH have the same contribution to this article; Zhang YS, Li XJ, Zhang YH and Hu TC designed the experiment; Chen WZ, Pan X and Chai HY drafted the work; Ye YC collected the data; Zhang YS and Li XJ analyzed and interpreted data; Zhang YH and Hu TC wrote the article.
Supported by Key R&D Plan of Science and Technology Program of Gansu Province, China, No. 19YF3FH001.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Dr. Ye reports grants from Key R&D plan of Science and Technology Program of Gansu Province, China. (NO. 19YF3FH001) during the conduct of the study.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Cheng Ye, PhD, Chief Doctor, Department of Heavy Ion Center, Wuwei Cancer Hospital, No. 31 Sanitary Alley, Haizang Road, Wuwei 733000, Gansu Province, China. zlyyyyc@163.com
Received: April 15, 2021
Peer-review started: April 15, 2021
First decision: May 10, 2021
Revised: May 15, 2021
Accepted: June 17, 2021
Article in press: June 17, 2021
Published online: August 6, 2021
Processing time: 103 Days and 16.5 Hours
Abstract
BACKGROUND

Although the bystander effect and abscopal effect are familiar in medicine, they are relatively rare in clinical practice. Herein, we report the case of a patient who demonstrated an obvious bystander effect and abscopal effect response following carbon-ion irradiation for recurrent thymic carcinoma.

CASE SUMMARY

A 44-year-old female presented with shortness of breath. Eleven years prior, she was diagnosed with athymic tumor located in the anterosuperior mediastinum. She underwent extensive tumor resection, and the postoperative pathologic diagnosis was thymic carcinoma. She was administered 50 Gy/25 Fx of postoperative radiation. In 2019, she was diagnosed with a recurrence of thymic carcinoma, with multiple recurrent nodules and masses in the left thoracic chest and peritoneal cavity, the largest of which was in the diaphragm pleura proximal to the pericardium, with a size of 6.7 cm × 5.3 cm × 4.8 cm. She received carbon-ion radiotherapy. After carbon-ion radiotherapy treatment, the treated masses and the untreated masses were observed to have noticeably shrunk on the day of carbon-ion radiotherapy completion and on follow-up imaging. We followed the CARE Guidelines for consensus-based clinical case reporting guideline development and completed the CARE Checklist of information to report this case.

CONCLUSION

This report is the first of obvious abscopal and bystander effects following carbon-ion irradiation in a human patient, and further research is needed to better elucidate the mechanisms of bystander and abscopal effects.

Keywords: Bystander effect; Abscopal effect; Recurrent thymic carcinoma; Carbon-ion radiation therapy; Case report

Core Tip: We presented the case of a patient who demonstrated a bystander effect and an abscopal effect following carbon-ion irradiation for recurrent thymic carcinoma. In this report, obvious abscopal and bystander effects after carbon-ion irradiation in a patient was initially presented, and more research is needed to further elucidate the mechanism of bystander and abscopal effects.