卡瑞利珠单抗联合立体定向体部放疗治疗晚期寡转移非小细胞肺癌的有效性和安全性研究  

A clinical study on the efficacy and safety of camrelizumab combined with stereotactic body radiation therapy in the treatment of advancedoligometastaticnon-small cell lung cancer

作　　者：陈洁[1] 刘德胜[2] 贾钰铭[1] 付茂月 舒艳玲 Chen Jie;Liu Desheng;Jia Yuming;Fu Maoyue;Shu Yanling(Tumor Center,the Second People′s Hospital of Yibin,Yibin 644000,China;Department of Thoracic and Cardiac Surgery,the Second People′s Hospital of Yibin,Yibin 644000,China)

机构地区：[1]宜宾市第二人民医院肿瘤中心,宜宾644000 [2]宜宾市第二人民医院胸心外科,宜宾644000

出　　处：《中国医师进修杂志》2022年第6期554-559,共6页Chinese Journal of Postgraduates of Medicine

基　　金：四川省宜宾市卫生健康委员会科研课题(2020YW065)。

摘　　要：目的探讨卡瑞利珠单抗联合立体定向体部放疗(SBRT)治疗晚期寡转移非小细胞肺癌(NSCLC)的有效性和安全性。方法将2020年3月至2021年8月宜宾市第二人民医院收治的符合纳入及排除标准的86例晚期寡转移NSCLC患者按随机数字表法分为对照组43例和治疗组43例,对照组给予卡瑞利珠单抗联合常规放疗,治疗组实施卡瑞利珠单抗联合SBRT治疗。治疗8周后评价两组疗效,统计两组毒副反应发生情况,检测两组治疗前、治疗8周后血清肿瘤标志物[癌胚抗原(CEA)、鳞状细胞癌抗原(SCC-Ag)、细胞角蛋白19片段抗21-1(Cyfra21-1)]水平。结果治疗组客观有效率明显较对照组高[72.09%(31/43)比51.16%(22/43)],差异有统计学意义(P<0.05);治疗组放射性肺炎发生率明显较对照组低[4.65%(2/43)比18.60%(8/43)],差异有统计学意义(P<0.05),而反应性皮肤毛细血管增生症、肝功能损害、甲状腺功能减退、放射性食管炎等其他毒副反应发生率和对照组比较差异均无统计学意义(P均>0.05);治疗后两组血清CEA、SCC-Ag、CYFRA21-1水平和治疗前比较均明显降低[治疗组:(8.81±4.82)ng/L比(81.67±50.88)ng/L、(1.13±0.55)ng/L比(1.56±1.03)ng/L和(2.92±0.99)ng/L比(4.63±1.39)ng/L;对照组:(30.49±19.44)ng/L比(89.91±50.10)ng/L、(1.56±1.23)ng/L比(1.86±1.33)ng/L和(4.01±2.10)ng/L比(5.03±3.44)ng/L],且治疗组治疗后均明显较对照组低,差异均有统计学意义(P均<0.05)。结论对晚期寡转移NSCLC患者实施卡瑞利珠单抗联合SBRT治疗,可有效下调患者血清CEA、SCC-Ag、CYFRA21-1水平,显著提高近期疗效,且毒副反应发生率相对较低。Objective To investigate the efficacy and safety of camrelizumab combined with stereotactic body radiation therapy(SBRT)in the treatment of advanced oligometastaticnon-small cell lung cancer(NSCLC).Methods Eighty-six patients with advanced oligometastatic NSCLC who met the inclusion and exclusion criteria from March 2020 to August 2021 in the Second People′s Hospital of Yibin were divided into the control group(43 cases)and the treatment group(43 cases)according to the random number table method,the control group was given camrelizumab combined with conventional radiotherapy,and the treatment group was given camrelizumab combined with SBRT.After 8 weeks of treatment,the efficacy of the two groups was evaluated,the occurrence of side effects in the two groups was counted,the serum tumor markers[carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCC-Ag),cytokeratin 19 fragment anti-21-1(CYFRA21-1)]levels were detected.Results The objective effective rate of the treatment group was significantly higher than that of the control group::72.09%(31/43)vs.51.16%(22/43),the difference was statistically significant(P<0.05);the incidence of radiation pneumonia in the treatment group was significantly lower than that in the control group:4.65%(2/43)vs.18.60%(8/43),the difference was statistically significant(P<0.05),and there was no significant difference in the incidences of other side effects such as cutaneous capillary endothelial proliferation(CCEP),liver damage,hypothyroidism,and radiation esophagitisbetween the treatment group and the control group(P>0.05);the levels of serum CEA,SCC-Ag,CYFRA21-1after treatmentin the two groups were significantly lower than those before treatment,treatment group:treatmentgroup:(8.81±4.82)ng/L vs.(81.67±50.88)ng/L,(1.13±0.55)ng/L vs.(1.56±1.03)ng/L and(2.92±0.99)ng/L vs.(4.63±1.39)ng/L,controlgroup:(30.49±19.44)ng/L vs.(89.91±50.10)ng/L,(1.56±1.23)ng/L vs.(1.86±1.33)ng/L and(4.01±2.10)ng/L vs.(5.03±3.44)ng/L.and the levels after treatment in the treatment group w

关 键 词：放射治疗计划 计算机辅助 卡瑞利珠单抗 立体定向体部放疗 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]