纳武单抗联合紫杉醇加顺铂化疗方案治疗晚期非鳞癌非小细胞肺癌的疗效及影响因素  

Efficacy and influencing factors of nivolumab combined with paclitaxel plus cisplatin chemotherapy in treatment of advanced non-squamous cell non-small cell lung cancer

作　　者：王丽华[1] 郭君兰[1] 胡彦伟 黄雪青 WANG Lihua;GUO Junlan;HU Yanwei;HUANG Xueqing(Internal Medicine,Anyang Tuomr Hospital,the Affiliated Anyang Tumor Hospital of Henan University of Science and Technology,Anyang 455000,China)

机构地区：[1]安阳市肿瘤医院,河南科技大学附属安阳市肿瘤医院内科学,安阳455000

出　　处：《中国免疫学杂志》2022年第12期1488-1493,共6页Chinese Journal of Immunology

摘　　要：目的:探讨纳武单抗联合紫杉醇加顺铂化疗方案治疗晚期非鳞癌非小细胞肺癌的疗效及影响因素。方法:选取2018年9月至2019年10月安阳市肿瘤医院收治的晚期非鳞癌非小细胞肺癌患者87例,根据患者病情和意愿分为对照组和观察组,对照组采用紫杉醇加顺铂化疗方案,观察组在紫杉醇加顺铂化疗方案基础上加用纳武单抗。比较两组的细胞免疫指标、细胞因子指标、近期疗效、不良反应及1年预后,分析近期疗效和1年预后的影响因素。结果:治疗后,观察组CD3^(+)T、CD4^(+)T淋巴细胞及CD4^(+)/CD8^(+)均升高,CD8^(+)T淋巴细胞、IL-6及TNF-α水平均降低,与对照组相比差异有统计学意义(P<0.05)。观察组近期疗效和1年预后均优于对照组,差异有统计学意义(P<0.05),而两组不良反应发生率差异无统计学意义(P>0.05)。低CD4^(+)/CD8^(+)、高TNF-α及紫杉醇加顺铂化疗是晚期非鳞癌非小细胞肺癌患者近期疾病进展和1年死亡的危险因素(P<0.05),此外临床分期Ⅳ期也是患者1年死亡的危险因素(P<0.05)。结论:纳武单抗联合紫杉醇加顺铂化疗方案治疗晚期非鳞癌非小细胞肺癌,可通过解除细胞免疫抑制状态,减轻炎症反应,进而提高近期疗效和1年生存率,且未提高严重不良反应发生率。Objective:To investigate the efficacy and influencing factors of nivolumab combined with paclitaxel plus cisplatin chemotherapy in treatment of advanced non-squamous cell non-small cell lung cancer.Methods:Total 87 patients with advanced non-squamous cell non-small cell lung cancer who were treated in Anyang Tumor Hospital from September 2018 to October 2019 were selected and divided into control group and observation group according to their condition and wishes.Control group received paclitaxel plus cisplatin chemotherapy,and observation group received nivolumab on the basis of paclitaxel plus cisplatin chemotherapy.Cellular immunity indexes,cytokine indexes,short-term efficacy,adverse reactions and 1 year prognosis of the two groups were compared,and influencing factors of short-term efficacy and 1 year prognosis were analyzed.Results:After treatment,CD3^(+)T,CD4^(+)T lymphocytes and CD4^(+)/CD8^(+)were all increased,while CD8^(+)T lymphocytes,IL-6 and TNF-αwere all decreased in observation group,with statistically significant differences compared with control group(P<0.05).Short-term efficacy and 1 year prognosis of observation group were better than that of control group,with statistically significant differences(P<0.05),while the incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Low CD4^(+)/CD8^(+),high TNF-αand paclitaxel plus cisplatin chemotherapy were risk factors for recent disease progression and 1-year death in patients with advanced non-squamous cell non-small cell lung cancer(P<0.05),and clinical stageⅣwas also a risk factor for 1-year death(P<0.05).Conclusion:Nivolumab combined with paclitaxel plus cisplatin chemotherapy in treatment of advanced non-squamous cell non-small cell lung cancer can relieve cellular immunosuppression state,reduce inflammatory response,thereby improving the short-term efficacy and 1 year prognosis,without increasing the incidence of serious adverse reactions.

关 键 词：纳武单抗 紫杉醇加顺铂化疗方案 晚期非鳞癌非小细胞肺癌 疗效 影响因素 

分 类 号：R979.1[医药卫生—药品]