信迪利单抗联合新辅助化疗在局部晚期食管癌治疗中的疗效分析  

Efficacy Analysis of Sintilimab Combined with Neoadjuvant Chemotherapy in Treatment of Locally Advanced Esophageal Cancer

作　　者：李春霖 刘迪 甘绍印 朱德奇[1] 李宾[1] 王永连[1] LI Chunlin;LIU Di;GAN Shaoyin;ZHU Deqi;LI Bin;WANG Yonglian(The First Affiliated Hospital of Xinxiang Medical University,Xinxiang,China,453100)

机构地区：[1]新乡医学院第一附属医院,河南新乡453100

出　　处：《食管疾病》2023年第4期269-274,共6页Journal of Esophageal Diseases

基　　金：新乡医学院第一附属医院青年基金项目(QN-2020-B05)。

摘　　要：目的评价信迪利单抗联合白蛋白结合型紫杉醇+奈达铂在局部晚期食管癌术前新辅助治疗中的临床效果。方法回顾性分析2019年1月至2021年12月新乡医学院第一附属医院胸外科接受术前新辅助治疗后行食管癌根治术患者82例的临床资料。根据治疗方案的不同,将患者分为A组40例和B组42例,A组患者术前予以信迪利单抗免疫治疗联合白蛋白结合型紫杉醇+奈达铂新辅助化疗,B组患者术前单纯予以白蛋白结合型紫杉醇+奈达铂新辅助化疗,两组患者均治疗两周期后行胸腹腔镜联合食管癌根治术。通过比较两组患者的基本资料、新辅助治疗期间化疗不良反应的发生情况、围手术期相关指标、术后病理反应进行评估。结果两组患者的基本资料无统计学差异(P>0.05);在新辅助治疗期间化疗不良反应两组比较差异无统计学意义(P>0.05);A组患者部分缓解率高于B组,疾病进展率低于B组,且客观缓解率(objective response rate,ORR)和疾病控制率(disease control rate,DCR)均优于B组,差异有统计学意义(P<0.05);两组患者的完全缓解率、疾病稳定率对比无统计学差异(P>0.05);两组患者的围手术期指标、术后吻合口瘘以及R0切除率比较差异无统计学意义(P>0.05);两组患者术后主要病理缓解率A组优于B组,差异有统计学意义(P<0.05),但在病理完全缓解率及无反应方面差异无统计学意义(P>0.05)。结论信迪利单抗联合白蛋白结合型紫杉醇及奈达铂的治疗优于单纯的白蛋白结合型紫杉醇及奈达铂的化疗,未增加明显的不良反应,而且患者的耐受性良好,提高了客观缓解率以及疾病控制率,改善了手术治疗的效果。Objective To study the clinical efficacy of sintilimab combined with albumin-bound paclitaxel+nedaplatin in preoperative neoadjuvant treatment of locally advanced esophageal cancer.Methods Retrospective analysis was used on the clinical data of 82 patients who received preoperative neoadjuvant treatment and then underwent radical resection of esophageal cancer in our hospital from January 2019 to December 2021.According to the different treatment plans,patients were divided into group A with 40 cases and group B with 42 cases.Before operation,group A patients received neoadjuvant chemotherapy with sintilimab immunotherapy combined with albumin bound paclitaxel+nedaplatin while group B patients received only albumin bound paclitaxel+nedaplatin neoadjuvant chemotherapy.Both groups underwent thoracoscopic esophageal cancer radical surgery after two cycles of treatment.The basic information,adverse reactions to chemotherapy during neoadjuvant therapy,perioperative indicators,and postoperative pathological response of the two groups were compared and evaluated.Results There was no statistically significant difference in the basic data between the two groups of patients.There was no statistically significant difference in the incidence of adverse reactions between the two groups.The partial response rate of group A patients was higher than that of group B,the disease progression rate is lower than that of group B;the objective response rate(ORR)and disease control rate(DCR)were better than those in group B(P<0.05).There was no statistically significant difference in the complete remission rate and disease stability rate between the two groups of patients.There was no statistically significant difference in perioperative indicators,postoperative anastomotic fistula,and R0 resection rate between the two groups of patients.The major pathologic response(MPR)rate of postoperative pathological reaction evaluation in group A was better than that in group B(P<0.05).There was no statistically significant difference in pathologi

关 键 词：信迪利单抗 新辅助化疗 食管癌 局部晚期 

分 类 号：R735.1[医药卫生—肿瘤]