不可逆电穿孔消融术联合程序性死亡蛋白-1抑制剂及化疗在局部进展期胰腺癌的临床疗效  

Clinical efficacy of IRE ablation combined with PD⁃1 inhibitor and chemotherapy in treatment of locally advanced pancreatic cancer

作　　者：张通 李晓勇[1] 陈艳军[1] 陈升阳[1] 胡水泉 程冰冰[1] 仝昊 宋立山 ZHANG Tong;LI Xiaoyong;CHEN Yanjun;CHEN Shengyang;HU Shuiquan;CHENG Bingbing;TONG Hao;SONG Lishan(The Fifth Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院,郑州450052

出　　处：《实用医学杂志》2023年第9期1153-1158,共6页The Journal of Practical Medicine

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20200473)。

摘　　要：目的评价不可逆电穿孔(IRE)消融术联合程序性死亡蛋白⁃1(PD⁃1)抑制剂及化疗治疗局部进展期胰腺癌(LAPC)的临床安全性和有效性。方法收集2019年5月至2020年12月于郑州大学第五附属医院住院治疗的26例LAPC患者临床资料,按术后治疗方式分为IRE联合PD⁃1抑制剂及化疗组(研究组)11例,IRE联合化疗组(对照组)15例,化疗方案均为mFOLFIRINOX。对两组患者术后并发症、辅助治疗期间不良反应情况、术前及术后不同时间点CA19⁃9、肿瘤患者生命质量量表FACT⁃G评分、术后6个月疾病控制及随访期内中位总生存期(OS)、中位无进展生存期(PFS)情况进行分析。结果两组患者术后1个月内无Clavien⁃DindoⅡ级以上并发症发生,差异无统计学意义(P>0.05);两组患者术后辅助治疗期间无3级以上不良反应发生,差异无统计学意义(P>0.05);两组术后1、4个月CA19⁃9水平呈整体降低趋势,与术前相比差异有统计学意义(P<0.05),两组术后1、4个月CA19⁃9水平与术前相比差异有统计学意义(P<0.05);两组术后1、4个月FACT⁃G评分呈整体升高趋势,与术前相比差异有统计学意义(P<0.05);术后6个月两组疾病缓解率(RR)、疾病控制率(DCR)差异无统计学意义(P>0.05);研究组中位OS及中位PFS均高于对照组(24个月vs.18个月,14个月vs.10个月),差异有统计学意义(P<0.05)。结论不可逆电穿孔消融术后联合PD⁃1抑制剂及化疗在LAPC治疗中安全性高,能延长患者的生存时间,提高生存质量。Objective To evaluate the clinical safety and efficacy of IRE ablation combined with PD⁃1 in⁃hibitors and chemotherapy in the treatment of locally advanced pancreatic cancer(LAPC).Methods The clini⁃cal data of 26 patients with LAPC who were hospitalized in the Fifth Affiliated Hospital of Zhengzhou University from May 2019 to December 2020 were collected and divided into 11 patients treated with IRE combined with PD⁃1 inhibitor and chemotherapy group as study group and 15 patients treated with IRE combined with chemotherapy as control group according to postoperative treatment.The chemotherapy regimens for all the patients were mFOLFIRI⁃NOX.The two groups were compared in terms of postoperative complications,adverse reactions during adjuvant therapy,CA19⁃9 and FACT⁃G scores at different time points before and after surgery,disease control 6 months af⁃ter surgery,median overall survival(OS)and median progression⁃free survival(PFS)during follow⁃up.Results No complications of Clavien⁃Dindo of gradeⅡI or above occurred in both groups within one month after surgery,and there was no statistical significance in the incidence of other complications between them(P>0.05).No ad⁃verse reactions of grade 3 or above occurred between the two groups during the postoperative adjuvant therapy,and there was no statistical significance in the incidence of other adverse reactions between them(P>0.05).The level of CA19⁃9 in the two groups showed an overall decreasing trend 1 and 4 months after surgery,and the difference was statistically significant compared with that before surgery(P<0.05).The level of CA19⁃9 in the two groups be⁃tween 1 and 4 months after surgery was statistically significantly decreased compared with that before surgery(P<0.05).The FACT⁃G scores of the two groups showed an overall increasing trend 1 month and 4 months after sur⁃gery,with statistical significance compared with that before surgery(P<0.05).There were no significant differenc⁃es in disease remission rate(RR)and dis

关 键 词：胰腺癌 纳米刀 联合 药物疗法 临床疗效 

分 类 号：R735.9[医药卫生—肿瘤]