PD-1抑制剂治疗终止后晚期食管癌患者后续治疗的临床研究  

Follow-up Treatment of Advanced Esophageal Squamous Cell Carcinoma After PD-1 Termination Therapy

作　　者：张康梅 郑智[1] 朱伟[1] ZHANG Kangmei;ZHENG Zhi;ZHU Wei(Jiangxi Cancer Hospital,Nanchang,330029)

机构地区：[1]江西省肿瘤医院,330029

出　　处：《实用癌症杂志》2021年第12期1974-1976,共3页The Practical Journal of Cancer

基　　金：2019年江西省卫生计生委科技计划项目(编号:20195423)。

摘　　要：目的研究PD-1抑制剂(programmed death 1)与化疗之间是否能产生协同或药物耐药逆转作用,为PD-1抑制剂治疗终止后的晚期食管鳞癌患者的后续治疗方案提供临床依据。方法选择接受PD-1抑制剂治疗终止后的晚期食管癌患者20例,随机分为治疗组、对照组,各10例。治疗组后续治疗采用常规化疗,对照组放弃化疗行支持治疗。对比2组患者的mPFS、DCR及血液系统的毒副作用及生活质量。结果mPFS治疗组为(127.90±24.32)天,对照组(71.80±16.50)天,2组mPFS具有统计学差异(P<0.05)。2组患者DCR相比,治疗组:80%,对照组:40%,2组差异不具有统计学意义(P>0.05)。治疗组相比于对照组未增加Ⅲ级以上严重不良反应,2组不良反应发生率比较差异无统计学意义(P>0.05)。治疗组患者生活质量评分明显高于对照组,差异具有统计学意义(P<0.05)。结论终止PD-1抑制剂治疗后的晚期食管鳞癌患者,进行常规化疗可有效延长患者中位无疾病进展生存期、提高疾病控制率,且不良反应可耐受,有利于提高患者生活质量。Objective To investigate whether synergistic or drug resistance reversal can be produced between PD-1inhibitor and chemotherapy,and provide a clinical reference for the follow-up treatment of patients with advanced esophageal squamous cell carcinoma who discontinued PD-1inhibitortreatment for various reasons after PD-1inhibitortreatment.Methods 20 patients with advanced esophageal cancer after termination of PD-1 inhibitor treatment were selected.They were randomly divided into the treatment group and the control group,with 10 cases in each group.The treatment group received chemotherapy,and the control group was not treated with chemotherapy.The toxicity and side effects of MPFs,DCR and blood system and quality of life were compared between the 2 groups.Results mPFS in the treatment group were(127.90±24.32)days,the control group were(71.80±16.50)days,The difference between the 2 groups was statistically significant(P<0.05).DCR in the treatment group was 80%,and 40%in the control group,with no statistically significant difference between the 2 groups(P>0.05).Before and after treatment,there was no increase of grade III or above serious adverse reactions in the treatment group compared with the control group,and there was no statistical significance in the incidence of toxic and side reactions between the 2 groups(P>0.05).The quality of life score in the treatment group was significantly higher than that in the control group,with statistical significance(P<0.05).Conclusion Patients with advanced esophageal squamous cell carcinoma treated with PD-1inhibitor and chemotherapy can help improve mPFS and DCR with tolerable side effects,and prolong the life quality of patients.

关 键 词：PD-1抑制剂终止治疗 晚期食管鳞癌 后续治疗方案 

分 类 号：R735.1[医药卫生—肿瘤]