12/10/2021 一大早空腹去做了PET-CT Scan。三天后报告出来了，靠肺门和左上肺中间的淋巴结没啥变化，胸壁上的几片病灶稍有减少。
没有想像中的那么好，起码没变遭。
12/15日上午，抽过血后，如约见了医生。历行询问检查后，仔细对比了这两次PET结果。医生也说前四轮化疗效果不好，提出了下一阶段的治疗方案。
有三个选择：
1. 转入维持治疗，去掉卡博，用Alimta + Keytruda每三周一次，直到………。
2. 放弃治疗，…………
3. 放疗干掉那两个淋巴结转移灶。
协商的结果是：先用选项1，四轮过后再做一次PET。根据结果再决定是否继续1，或转选项3。
另外，约了两天后做EKG。
11:50 AM 进了化疗区开始点药。少了一剂，很快打完走人。
回家吃过中饭，咪了一会儿。
去了最毒的卡博，反应不是很重。
晚上睡不着，大概受激素的影响。半夜服了一片Benadryl, 勉强睡了几个小时。
12/16日 早上没有像前几轮化疗第二天一样服用激素和防呕抗便秘的药，这一天也挺下来了。
照常工作，远程开会。
这次化验检查结果显示，肝、肾功能尚好。血像也行，只是红细胞有些下降。大概与过去几周没买到猪肝有关吧。
前几天跟食品店老板联系过了，已到货，明天去取。猪肝不能冻，只能新鮮的煮过罐装分食。每次不能买太多。
自第四次化疗后，停了各种免疫增强剂。这次的CEA下降了约10%，不如上次那么显著。
12/17日，上午如约做了EKG, 没有异常。
Normal sinus rhythm
Normal ECG
When compared with ECG of 24-AUG-2016 08:50,
No significant change was found
附
PET报告
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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