PD-1/PD-L1抑制剂联合适形调强放射治疗对中晚期直肠癌患者生存时间及不良反应的影响  

Effect of PD-1/PD-L1 inhibitor combined with conformal intensity-modulated radiotherapy on survival time and adverse reactions of patients with advanced rectal cancer

作　　者：荣丽雯 凌华[1] 何雨歆 袁梦珍 张军[1] RONG Liwen;LING Hua;HE Yuxin;YUAN Mengzhen;ZHANG Jun(The Second Department of Oncology,Chengdu Third People's Hospital,Chengdu 610000,China)

机构地区：[1]成都市第三人民医院肿瘤二科,四川成都610000

出　　处：《西部医学》2022年第9期1347-1350,共4页Medical Journal of West China

基　　金：四川省科技厅项目(2015JY0096)。

摘　　要：目的研究程序性死亡分子1(PD-1)PD-1配体(PD-L1)抑制剂联合适形调强放射治疗对中晚期直肠癌患者生存时间及不良反应的影响。方法选取2015年5月~2018年2月我院收治的136例中晚期直肠癌患者随机均分为观察组(PD-1/PD-L1抑制剂联合适形调强放射治疗)和对照组(适形调强放射治疗)各68例。比较两组疗效,治疗前及治疗3个月后疾病相关因子[脂肪酸合成酶(FAS)、肿瘤M2丙酮酸激酶(TuM2-PK)]、生活质量[卡诺夫斯基健康状况量表(KPS)、生活质量自评量表(QOL)]水平,生存率、不良反应发生情况。结果两组疗效比较差异无统计学意义(P>0.05)。治疗3个月后,观察组FAS、TuM2-PK水平明显低于治疗前及同期对照组,KPS、QOL评分明显高于治疗前及同期对照组(P<0.05)。观察组第1年生存率、第2年生存率明显高于对照组(P<0.05);两组第3年生存率比较差异无统计学意义(P>0.05)。两组不良反应发生情况比较差异无统计学意义(P>0.05)。结论PD-1/PD-L1抑制剂联合适形调强放射治疗能够显著延长中晚期直肠癌患者生存时间,提升生活质量。Objective To study the effect of programmed death molecule 1(PD-1)PD-1 ligand(PD-L1)inhibitor combined with conformal intensity-modulated radiotherapy on survival time and adverse reactions of patients with advanced rectal cancer.Methods Totally 136 patients with advanced rectal cancer in our hospital were selected between May 2015 and February 2018 and were randomly divided into observation group(PD-1/PD-L1 inhibitor combined with conformal intensity-modulated radiotherapy)and control group(conformal intensity-modulated radiotherapy),with 68 cases in each group.The efficacy of the two groups was compared,and the disease-related factors[fatty acid synthase(FAS),tumor M2 pyruvate kinase(TuM2-PK)]and quality of life[Karnofsky Performance Scale(KPS),Quality of Life Scale(QOL)]were compared between the two groups before treatment and after 3 months of treatment.The survival rate and occurrence of adverse reactions were compared between the two groups.Results There was no significant difference in efficacy between the two groups(P>0.05).After 3 months of treatment,the levels of FAS and TuM2-PK in observation group were significantly lower than those before treatment and those in control group during the same period while the scores of KPS and QOL were significantly higher than those before treatment and those in control group during the same period(P<0.05).The first-year survival rate and the second-year survival rate of observation group were significantly higher than those of control group(P<0.05).There was no significant difference in the third-year survival rate between the two groups(P>0.05).There were no significant differences in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion PD-1/PD-L1 inhibitor combined with conformal intensity-modulated radiotherapy can significantly prolong the survival time and improve the quality of life of patients with advanced rectal cancer.

关 键 词：PD-1/PD-L1抑制剂 适形调强放射治疗 直肠癌 生存时间 不良反应 

分 类 号：R735.3[医药卫生—肿瘤]