PD-1单抗联合GC化疗治疗晚期尿路上皮癌的疗效及对肿瘤恶性程度的影响  

Efficacy of PD-1 monoclonal antibody combined with GC chemotherapy in treating advanced urothelial carcinoma and its effect on tumor malignant degree

作　　者：刘文辉 沈宏亮[1] LIU Wenhui;SHEN Hongliang(Department of Urological Surgery,Affiliated Beijing Friendship Hospital,Capital Medical University,Beijing 101125,China)

机构地区：[1]首都医科大学附属北京友谊医院泌尿外科,北京101125

出　　处：《重庆医学》2023年第21期3274-3278,3282,共6页Chongqing medicine

摘　　要：目的观察程序性死亡受体-1(PD-1)单抗联合吉西他滨+顺铂(GC)化疗治疗晚期尿路上皮癌的疗效及对肿瘤恶性程度的影响,为疾病治疗方式选择提供参考。方法将该院2019年1月至2020年6月收治的64例晚期尿路上皮癌患者作为研究对象,以随机数字表法分为联合组、化疗组,各32例。化疗组予以GC化疗,联合组予以PD-1单抗联合GC化疗,均治疗6周。比较2组治疗6周后疗效,治疗前、治疗3周、治疗6周后血清肿瘤标志物[糖类抗原125(CA125)、肿瘤特异性生长因子(TSGF)、细胞角蛋白19片段(CYFRA21-1)]水平,并统计不良反应发生率,随访观察18个月内生存情况。结果联合组、化疗组在疾病缓解率、疾病控制率方面比较差异无统计学意义(P>0.05);与治疗前比较,2组治疗3、6周后血清CA125、TSGF、CYFRA21-1水平均下降,且联合组下降更明显(P<0.05);治疗期间联合组皮疹、乏力发生率较化疗组更高(P<0.05),2组在肺炎、发热、视力模糊、外周神经毒性、口腔黏膜炎、脱发、肝功能损害、肾功能损害、胃肠道反应、贫血、血小板减少症、白细胞减少症发生率方面差异无统计学意义(P>0.05);联合组治疗后18个月生存率为61.29%,高于化疗组的30.00%(P<0.05)。结论应用PD-1单抗联合GC化疗治疗晚期尿路上皮癌可降低肿瘤恶性程度,延长患者生存时间,且可获得良好安全性,但需注意防范皮疹、乏力不良反应发生。Objective To observe the efficacy of programmed death receptor-1(PD-1)monoclonal antibody combined with gemcitabine+cisplatin(GC)chemotherapy in the treatment of advanced urothelial carcinoma and its effect on the degree of malignancy,so as to provide some reference for the choice of disease treatment mode.Methods A total of 64 patients with advanced urothelial carcinoma admitted and treated in this the hospital from January 2019 to June 2020 were selected as the research subjects and divided into the combination group and chemotherapy group by the random number table method,32 cases in each group.The chemotherapy group was treated with the GC chemotherapy,and the combined group was given the PD-1 monoclonal antibody combined with the GC chemotherapy.All patients were treated for 6 weeks.The curative effects after 6 weeks of treatment,the levels of serum tumor markers[carbohydrate antigen 125(CA125),tumor specific growth factor(TSGF)and cytokeratin 19 fragment(CYFRA21-1)]before treatment,in 3,6 weeks after treatment were compared between the two groups.The adverse reaction occurrence rate and survival within 18 months were observed by follow up.Results There was no statistical difference in the disease remission rate and disease control rate between the combination group and chemotherapy group(P>0.05);compared with before treatment,the serum CA125,TSGF and CYFRA21-1 levels after 3-week,6-week treatment in the two groups were decreased,moreover the decrease in the combined group was more obvious(P<0.05);the incidence rates of rash and fatigue in the combination group was higher than those in the chemotherapy group(P<0.05);there was no statistical difference in the incidence rates of pneumonia,fever,blurred vision,peripheral neurotoxicity,oral mucositis,hair loss,liver function damage,renal function damage,gastrointestinal reaction,anemia,thrombocytopenia and leucopenia between the two groups(P>0.05);the survival rate after 18-month treatment in the combined group was 61.29%,which was higher than 30.00%in the chemo

关 键 词：程序性死亡受体-1单抗 吉西他滨 顺铂 尿路上皮癌 肿瘤恶性程度 

分 类 号：R737.1[医药卫生—肿瘤]