程序性死亡受体1抑制剂联合化疗治疗晚期非小细胞肺癌患者的临床疗效及对甲状腺功能的影响  

Clinical efficacy of programmed cell death 1 inhibitor combined chemotherapy in the treatment of advanced non-small cell lung cancer and the influence on thyroid function

作　　者：李杨[1] 闫艳菊[1] 陈贡斌[1] 周倩宇 LI Yang;YAN Yanju;CHEN Gongbin;ZHOU Qianyu(Department of Medical Oncology,the First People’s Hospital of Shangqiu City,Shangqiu 476100,He’nan,China)

机构地区：[1]商丘市第一人民医院肿瘤内科,河南商丘476100

出　　处：《癌症进展》2022年第4期353-356,共4页Oncology Progress

摘　　要：目的探讨程序性死亡受体1(PD-1)抑制剂联合化疗治疗晚期非小细胞肺癌(NSCLC)患者的临床疗效及对甲状腺功能的影响。方法根据治疗方法的不同将56例晚期NSCLC患者分为对照组(n=30,采取常规化疗方案)和联合组(n=26,采取PD-1抑制剂联合化疗)。比较两组患者的临床疗效、甲状腺功能指标[促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT_(3))、总甲状腺素(TT_(4))、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))]、自身免疫性甲状腺炎诊断指标[抗甲状腺球蛋白抗体(anti-TGAb)、抗甲状腺过氧化物酶自身抗体(anti-TPOAb)]及不良反应发生情况。结果联合组患者的客观缓解率(ORR)和疾病控制率(DCR)分别为42.31%和80.77%,与对照组患者的26.67%和70.00%比较,差异均无统计学意义(P﹥0.05)。治疗后,两组患者的TSH水平均高于本组治疗前,TT_(3)、TT_(4)、FT_(3)、FT_(4)水平均低于本组治疗前,且联合组患者的TSH水平高于对照组,TT_(3)、TT_(4)、FT_(3)、FT_(4)水平均低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者的anti-TGAb、anti-TPOAb水平均高于本组治疗前,且联合组患者的anti-TGAb、anti-TPOAb水平均高于对照组,差异均有统计学意义(P﹤0.05)。两组患者骨髓抑制、皮疹、恶心呕吐、肝肾功能不全及治疗相关性肺炎的发生情况比较,差异均无统计学意义(P﹥0.05);联合组患者腹痛腹泻情况轻于对照组,差异有统计学意义(P﹤0.05)。结论PD-1抑制剂联合化疗治疗晚期NSCLC患者的临床疗效较好,且不良反应可耐受,但治疗过程中应对甲状腺激素水平进行监视,避免全身性代谢异常综合征出现。Objective To investigate the clinical efficacy of programmed cell death 1(PD-1)inhibitor combined chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC)and the influence on thyroid function.Method A total of 56 advanced NSCLC patients were divided into control group(n=30,receive conventional chemotherapy regimen)and combined group(n=26,receive PD-1 inhibitor combined chemotherapy)according to different treatment methods.Clinical efficacy,thyroid function indicators[thyroid stimulating hormone(TSH),total triiodothyronine(TT_(3)),total thyroxine(TT_(4)),free triiodothyronine(FT_(3)),free thyroxine(FT_(4))],autoimmune thyroiditis diagnosis index[anti-thyroglobulin antibody(anti-TGAb),anti-thyroid peroxidase autoantibody(anti-TPOAb)],and the occurrence of adverse reactions were compared between the two groups.Result The objective response rate(ORR)and disease control rate(DCR)of the combined group were 42.31% and 80.77%,respectively,which were higher than those of the control group(26.67% and 70.00%)with no statistical significance(P>0.05).After treatment,the levels of TSH in the two groups were significantly higher than those in the same group before treatment,the levels of TT_(3),TT_(4),FT_(3) and FT_(4) were significantly lower than those in the same group before treatment,with higher TSH level and lower TT_(3),TT_(4),FT_(3) and FT_(4) levels in the combined group than those in the control group(P<0.05).After treatment,the levels of anti-TGAb and anti-TPOAb in the two groups were significantly higher than those in the same group before treatment,with higher levels in the combined group than those in the control group(P<0.05).There were no statistically significant differences in the incidence of bone marrow suppression,rash,nausea and vomiting,hepatic and renal dysfunction,and treatment-related pneumonia between the two groups(P>0.05).The abdominal pain and diarrhea in the combined group was slighter than that in the control group(P<0.05).Conclusion PD-1 inhibitor combined with chemotherapy ha

关 键 词：程序性死亡受体1 免疫检查点抑制剂 化疗 非小细胞肺癌 甲状腺功能 

分 类 号：R734.2[医药卫生—肿瘤]