纳武利尤单抗联合替莫唑胺同步放疗治疗老年晚期小细胞肺癌脑转移的疗效  

Effects of nivolumab combined with temozolomide concurrent radiotherapy on brain metastases of advanced small cell lung cancer in the elderly

作　　者：石玲[1] 梅耀国 李道生 SHI Ling;MEI Yaoguo;LI Daosheng(Department of Oncology,the First People's Hospital of Jiujiang City,Jiangxi,Jiujiang 332000,China;Department of Oncology,Jiujiang Traditional Chinese Medicine Hospital,Jiangxi,Jiujiang 332000,China)

机构地区：[1]九江市第一人民医院肿瘤科,江西九江332000 [2]九江市中医医院肿瘤科,江西九江332000

出　　处：《中国现代医生》2022年第25期55-58,共4页China Modern Doctor

基　　金：江西省卫生健康委科技计划项目(220219689)。

摘　　要：目的分析纳武利尤单抗联合替莫唑胺(temozolomide,TMZ)同步放疗治疗老年晚期小细胞肺癌(small cell lung cancer,SCLC)脑转移的疗效。方法选择2017年1月至2020年12月于九江市第一人民医院治疗的72例老年晚期SCLC脑转移患者,根据随机数字表法将其分为两组,每组各36例。对照组患者采用TMZ同步放疗治疗,观察组患者采用纳武利尤单抗联合TMZ同步放疗。比较两组患者的临床疗效、血清肿瘤标志物水平、总生存(overall survival,OS)时间、无进展生存(progress free survival,PFS)时间、生存质量及不良反应。结果观察组患者的疾病控制率显著高于对照组(P<0.05);治疗后,观察组患者的血清胃泌素释放肽前体(progastrin releasing peptide,ProGRP)、神经元特异性烯醇化酶(neuron specific enolase,NSE)水平均显著低于对照组(P<0.05),OS、PFS时间均显著长于对照组(P<0.05),生存质量显著优于对照组(P<0.05)。两组患者的肝功能损害、消化道反应、血小板减少、白细胞减少、骨髓抑制发生率比较,差异均无统计学意义(P>0.05)。结论老年晚期SCLC脑转移患者采用纳武利尤单抗联合TMZ同步放疗可缩小颅内病灶,降低ProGRP、NSE水平,延长患者生存期,提高患者生活质量,且安全可靠。Objective To evaluate the efficacy of nivolumab combined with temozolomide(TMZ)concurrent radiotherapy in the treatment of brain metastases in advanced small cell lung cancer(SCLC).Methods A total of 72 elderly patients with advanced SCLC brain metastases who were treated in the First People's Hospital of Jiujiang City from January 2017 to December 2020 were selected and divided into two groups according to the random number table method,with 36 cases in each group.Patients in control group was treated with TMZ concurrent radiotherapy,and patients in observation group was treated with nivolumab combined with TMZ concurrent radiotherapy.The clinical efficacy,serum tumor marker levels,overall survival(OS),progress free survival(PFS),quality of life and adverse reactions were compared between the two groups.Results The disease control rate in observation group was higher than that in control group(P<0.05).After treatment,the serum levels of progastrin releasing peptide(ProGRP)and neuron specific enolase(NSE)in observation group were significantly lower than those in control group(P<0.05),the OS and PFS time were significantly longer than those in control group(P<0.05),and the quality of life was significantly better than that in control group(P<0.05).There was no significant difference in the incidence of liver function damage,digestive tract reaction,thrombocytopenia,leukopenia,and bone marrow suppression between the two groups(P>0.05).Conclusion In elderly patients with advanced SCLC brain metastasis,the combination of nivolumab and TMZ synchronous brain radiotherapy can reduce intracranial lesions,reduce ProGRP and NSE levels,prolong the survival of patients,and improve the quality of life of patients,which is safe and reliable.

关 键 词：小细胞肺癌 纳武利尤单抗 替莫唑胺 同步放疗 肿瘤标志物 生存率 生存质量 不良反应 

分 类 号：R734.2[医药卫生—肿瘤]