调强放疗联合PD-1/PD-L1阻断疗法对中晚期非小细胞肺癌患者免疫状态及近期预后的影响  

Effects of Intensity Modulated Radiotherapy Combined with PD-1/PD-L1 Blocking Therapy on Immune Status and Short-term Prognosis in Advanced Non-small Cell Lung Cancer

作　　者：郑大炜[1] 郭娜[1] 孙辉[1] ZHENG Dawei;GUO Na;SUN Hui(Nanyang Central Hospital,Nanyang,473000)

机构地区：[1]河南省南阳市中心医院,473000

出　　处：《实用癌症杂志》2022年第7期1165-1169,共5页The Practical Journal of Cancer

基　　金：河南省中医药科学研究专项课题(编号:20-21ZY2298)。

摘　　要：目的研究调强放疗联合程序性死亡分子1(PD-1)/程序性死亡分子配体1(PD-L1)阻断疗法对中晚期非小细胞肺癌(NSCLC)患者免疫状态及近期预后的影响。方法选择64例NSCLC患者,按随机数表法分为观察组和对照组,各32例。对照组单纯接受调强放疗治疗,观察组采用调强放疗联合PD-1/PD-L1阻断疗法方案治疗。观察2组近期临床疗效、肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA-125)、糖类抗原199(CA-199)]水平、免疫功能恢复情况、血管功能变化、近期预后和放疗不良反应的发生。结果治疗后,观察组临床总有效率高于对照组(P<0.05)。观察组CEA、CA-125、CA-199水平均低于对照组(P<0.05);观察组免疫功能恢复情况优于对照组(P<0.05);观察组血管内皮生长因子、基质金属蛋白酶水平均低于对照组(P<0.05)。观察组治疗期间放疗不良反应发生率低于对照组(P<0.05)。结论调强放疗联合PD-1/PD-L1阻断疗法可使中晚期NSCLC患者显著获益,增强机体免疫功能、抑制肿瘤生长、改善近期预后生存,减少不良反应的发生。Objective To study the effects of intensity modulated radiotherapy(IMRT)combined with programmed death-1(PD-1)/programmed death ligand-1(PD-L1)blocking therapy on immune status and short-term prognosis in advanced non-small cell lung cancer(NSCLC).Methods 64 patients with NSCLC were enrolled.They were divided into the observation group and the control group according to random number table method,32 cases in each group.The control group only underwent IMRT,while the observation group additionally underwent PD-1/PD-L1 blocking therapy.The short-term clinical curative effect,levels of tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA-125),carbohydrate antigen 199(CA-199)],recovery of immune function,changes of vascular function,short-term prognosis and the occurrence of adverse radiotherapy reactions in both groups were observed.Results After treatment,total clinical response rate of the observation group was higher than that of the control group(P<0.05).The levels of CEA,CA-125 and CA-199 in the observation group were lower than those in the control group(P<0.05),recovery of immune function was better than that in the control group(P<0.05),levels of vascular endothelial growth factor and matrix metalloproteinase were lower than those in the control group(P<0.05),and incidence of adverse radiotherapy reactions during treatment was lower than that in control group(P<0.05).Conclusion IMRT combined with PD-1/PD-L1 blocking therapy can significantly improve patients with advanced NSCLC,which can enhance immune function,inhibit growth of tumors,improve short-term prognosis and survival,and reduce the occurrence of adverse reactions.

关 键 词：调强放疗 程序性死亡分子1 程序性死亡分子配体1 阻断疗法 中晚期非小细胞肺癌 免疫状态 近期预后 

分 类 号：R734.2[医药卫生—肿瘤]