樵客
講述親身經曆，感悟天地人生
12/10/2021 一大早空腹去做了PET-CT Scan。三天後報告出來了，靠肺門和左上肺中間的淋巴結沒啥變化，胸壁上的幾片病灶稍有減少。
沒有想像中的那麽好，起碼沒變遭。
12/15日上午，抽過血後，如約見了醫生。曆行詢問檢查後，仔細對比了這兩次PET結果。醫生也說前四輪化療效果不好，提出了下一階段的治療方案。
有三個選擇：
1. 轉入維持治療，去掉卡博，用Alimta + Keytruda每三周一次，直到………。
2. 放棄治療，…………
3. 放療幹掉那兩個淋巴結轉移灶。
協商的結果是：先用選項1，四輪過後再做一次PET。根據結果再決定是否繼續1，或轉選項3。
另外，約了兩天後做EKG。
11:50 AM 進了化療區開始點藥。少了一劑，很快打完走人。
回家吃過中飯，咪了一會兒。
去了最毒的卡博，反應不是很重。
晚上睡不著，大概受激素的影響。半夜服了一片Benadryl, 勉強睡了幾個小時。
12/16日 早上沒有像前幾輪化療第二天一樣服用激素和防嘔抗便秘的藥，這一天也挺下來了。
照常工作，遠程開會。
這次化驗檢查結果顯示，肝、腎功能尚好。血像也行，隻是紅細胞有些下降。大概與過去幾周沒買到豬肝有關吧。
前幾天跟食品店老板聯係過了，已到貨，明天去取。豬肝不能凍，隻能新鮮的煮過罐裝分食。每次不能買太多。
自第四次化療後，停了各種免疫增強劑。這次的CEA下降了約10%，不如上次那麽顯著。
12/17日，上午如約做了EKG, 沒有異常。
Normal sinus rhythm
Normal ECG
When compared with ECG of 24-AUG-2016 08:50,
No significant change was found
附
PET報告
Impression
1. Markedly hypermetabolic left paraesophageal and left hilar lymph
nodes not significantly changed from prior study.
2. Redemonstration of loculated pleural effusion, all previously seen
pleural findings with associated pleural irregularity as described
above.
3. Persistent mild, improved hypermetabolism associated with airspace
opacity adjacent to loculated pleural effusion may represent
atelectatic changes though underlying mass or concurrent infectious
process cannot be definitively excluded.
……………
THORAX: Atherosclerotic calcification of thoracic aorta. Mild coronary
opacities in the LAD and RCA. Non FDG avid normal-appearing axillary
lymph nodes. Persistent markedly hypermetabolic subcentimeter left
hilar lymph nodes measuring up to 6 mm, SUV 4.1 (prior measuring up to
6 mm, SUV 3.2). Persistent marked hypermetabolism in a subcentimeter
left paraesophageal lymph node, SUV 3.1 (prior SUV 4.5). Loculated
left pleural effusion not significantly changed from prior study.
Persistent mild hypermetabolism along its inferior aspect similar to
that seen on the prior study, SUV 2.3 with grossly stable pleural
thickening. Mild hypermetabolism associated with the pleural
thickening of the left hemithorax at the superior aspect with pleural
thickening/irregularity along the mediastinal pleura grossly unchanged
from prior study. Mild hypermetabolism associated with opacity at the
left lung base adjacent to the pleural effusion, SUV 2.6 (prior SUV
3.2) may represent atelectatic changes though underlying lesions cannot
be definitively excluded. Interval improvement in previously seen FDG
avid thickening along the left lateral chest wall.
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