替雷利珠单抗联合铂类治疗中晚期非小细胞肺癌的近期疗效和安全性研究  

Short-term efficacy and safety of tirelizumab combined with platinum in the treatment of advanced non-small cell lung cancer

作　　者：陈方[1] 梁海[2] 程刚[1] 蒋祥德[1] 张华鹏[1] 王磊[1] CHEN Fang;LIANG Hai;CHENG Gang(Department of Medical Oncology,Bozhou People's Hospital,Bozhou Anhui 236800,China;Department of Pharmacy,Bozhou People's Hospital,Bozhou Anhui 236800,China)

机构地区：[1]亳州市人民医院肿瘤科,安徽亳州236800 [2]亳州市人民医院药剂科,安徽亳州236800

出　　处：《临床和实验医学杂志》2023年第6期583-587,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省重点研究与开发计划项目(编号:2022e07020066)。

摘　　要：目的评价替雷利珠单抗联合铂类治疗中晚期非小细胞肺癌(NSCLC)的近期疗效和安全性。方法回顾性分析2021年5月至2022年7月亳州市人民医院收治的中晚期NSCLC患者60例,根据治疗方式不同分为化疗组(铂类方案化疗)和联合组(替雷利珠单抗+铂类方案化疗),每组30例,两组均治疗3个周期,每个周期21 d。评价两组的近期疗效、肿瘤标志物[癌胚抗原(CEA)、癌抗原125(CA125)、细胞角蛋白19的可溶性片段(CYFRA21-1)和鳞状上皮细胞癌抗原(SCC)]、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、系统性免疫性炎症指数(SII)水平、生活质量及化疗毒副作用等指标,并进行统计比较。结果联合组客观有效率66.67%,疾病控制率86.67%,联合组客观有效率和疾病控制率均显著高于化疗组(26.67%、53.33%),差异均有统计学意义(P<0.05);联合组治疗后血清CEA、CA125、CYFRA21-1和SCC水平为(8.71±1.56)ng/mL、(42.10±6.31)U/mL、(4.74±1.13)ng/mL、(18.17±3.16)ng/mL,均明显低于化疗组[(17.48±1.62)ng/mL、(50.88±7.90)U/mL、(7.12±1.88)ng/mL、(28.26±4.36)ng/mL],差异均有统计学意义(P<0.05)。联合组治疗后NLR、PLR和SII为2.11±1.17、112.26±31.92、138.92±28.93,显著低于化疗组(2.82±1.32、138.64±37.28、217.85±42.18),差异均有统计学意义(P<0.05)。联合组治疗后FACT-L量表各维度得分为(22.03±4.28)、(20.46±4.57)、(19.55±4.12)、(22.42±4.21)、(27.74±4.35)、(112.18±17.06)分,均显著高于化疗组[(19.14±3.80)、(18.15±4.24)、(16.82±3.86)、(19.44±3.91)、(25.13±4.16)、(99.87±16.15)分],差异均有统计学意义(P<0.05)。联合组毒副反应发生率为16.67%,低于化疗组(46.67%),差异有统计学意义(P<0.05)。结论替雷利珠单抗联合铂类可有效提高中晚期NSCLC的近期疗效,控制血清肿瘤标志水平,缓解机体炎症反应,改善患者的生活质量,且安全性良好。Objective To evaluate the short-term efficacy and safety of tirelizumab combined with platinum in the treatment of advanced non-small cell lung cancer(NSCLC).Methods In this study,which was a retrospective analysis,60 patients with intermediate to advanced NSCLC admitted to Bozhou People's Hospital from May 2021 to July 2022 were selected and divided into chemotherapy group(platinum-based regimen chemotherapy)and combination group(tirelizumab+platinum-based regimen chemotherapy)according to the treatment modality,30 cases in each group,and both groups were treated for 3 cycles of 21 d each.The recent efficacy,tumor marker levels[carcinoembryonic antigen(CEA),cancer antigen 125(CA125),soluble fragment of cytokeratin 19(CYFRA21-1)and squamous cell carcinoma antigen(SCC)],neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),systemic immune inflammatory index(SII),quality of life and side effects of chemotherapy were evaluated and statistically compared between the two groups.Results The objective effective rate in the combination group was 66.67%and the disease control rate was 86.67%,the objective effective rate and disease control rate in the combination group were significantly higher than those in the chemotherapy group(26.67%,53.33%),the differences were statistically significant(P<0.05).The levels of serum CEA,CA125,CYFRA21-1 and SCC in the combination group after treatment were(8.71±1.56)ng/mL,(42.10±6.31)U/mL,(4.74±1.13)ng/mL,(18.17±3.16)ng/mL,which were significantly lower than those in the chemotherapy group[(17.48±1.62)ng/mL,(50.88±7.90)U/mL,(7.12±1.88)ng/mL,(28.26±4.36)ng/mL]in the combination group,the differences were statistically significant(P<0.05).NLR,PLR and SII were 2.11±1.17,112.26±31.92,138.92±28.93 in the combination group after treatment,which were significantly lower than in the chemotherapy group(2.82±1.32,138.64±37.28,217.85±42.18),the differences were statistically significant(P<0.05).The post-treatment FACT-L scale scores for each dimension were(22.03±4.28),(20.

关 键 词：中晚期非小细胞肺癌 替雷利珠单抗 铂类 化疗 近期疗效 安全性 

分 类 号：R734.2[医药卫生—肿瘤]