Table_1_Apatinib manifests an unexpectedly favorable outcome in the management of axillary lymph node follicular dendritic cell sarcoma: a case report.docx

We present a case of follicular dendritic cell sarcoma in the axillary lymph node, which unexpectedly showed favorable outcomes after the application of apatinib. Follicular Dendritic Cell Sarcoma (FDCS) exhibits a rare incidence and an unclear pathogenic mechanism, contributing to the limited breakthroughs in its treatment to date within the medical field. The current mainstream therapeutic approaches include surgery, CHOP(cyclophosphamide, doxorubicin, vincristine, prednisone), ICE(ifosfamide, carboplatin, etoposide), ABVD(doxorubicin, bleomycin, vinblastine, dacarbazine), and immune checkpoint inhibitors. A 38-year-old male patient was admitted to the hospital due to a lump in the right axilla and underwent surgical treatment. Postoperative pathology confirmed the diagnosis of follicular dendritic cell sarcoma. Two months post-surgery, he faced a recurrence, prompting a subsequent surgical intervention complemented by tumor radiofrequency ablation. Despite these interventions, the treatment response was suboptimal. Subsequently, the patient was treated with the CHOP regimen, but after two cycles, he developed bone metastasis. Due to the patient's limited financial resources and refusal of immunotherapy, we switched to a regimen of gemcitabine and docetaxel, but the disease progressed again after two cycles. A one-cycle trial of albumin-bound paclitaxel yielded unsatisfactory results. Ultimately, the patient was treated with Apatinib, achieving a 10-month progression-free survival. Due to the patient's limited financial circumstances, we, in the absence of guideline recommendations and evidence from evidence-based medicine, achieved a 10-month progression-free survival (PFS) solely based on experiential use of the anti-angiogenic drug, Apatinib. The purpose of this case report is to provide additional therapeutic options for FDCS treatment and to pave the way for exploring the mechanism of action of Apatinib in FDCS.

本团队报告1例腋窝淋巴结滤泡树突状细胞肉瘤（Follicular Dendritic Cell Sarcoma, FDCS）病例，该患者接受阿帕替尼（apatinib）治疗后获得了意外的良好疗效。滤泡树突状细胞肉瘤（FDCS）发病率罕见，致病机制尚未明确，导致目前医学界在其治疗领域鲜有突破。当前主流治疗方案包括手术治疗、CHOP方案（环磷酰胺、多柔比星、长春新碱、泼尼松）、ICE方案（异环磷酰胺、卡铂、依托泊苷）、ABVD方案（多柔比星、博来霉素、长春花碱、达卡巴嗪）以及免疫检查点抑制剂。本研究纳入1例因右侧腋窝肿块就诊的38岁男性患者，行手术切除治疗，术后病理确诊为滤泡树突状细胞肉瘤。术后2个月患者出现肿瘤复发，再次接受手术治疗联合肿瘤射频消融，但疗效欠佳。随后予CHOP方案化疗，2个周期后出现骨转移。因患者经济条件有限且拒绝免疫治疗，遂更换为吉西他滨联合多西他赛方案化疗，但2个周期后病情仍出现进展。予1周期白蛋白结合型紫杉醇治疗，疗效仍未达预期。最终予阿帕替尼治疗，患者获得10个月的无进展生存期（progression-free survival, PFS）。鉴于患者经济拮据，且无指南推荐及循证医学证据支持，本团队凭借经验性使用抗血管生成药物阿帕替尼，使患者达成了10个月的无进展生存期（PFS）。本病例报告旨在为FDCS的临床治疗提供额外可选方案，并为探索阿帕替尼治疗FDCS的作用机制奠定研究基础。