碘125粒子植入联合PD-1单抗加含铂化疗治疗晚期非小细胞肺癌的有效性及安全性  

Efficacy and safety of iodine-125 particle implantation combined with PD-1 monoclonal antibody and platinum-based chemotherapy in the treatment of advanced non-small cell lung cancer

作　　者：沈艳丽 李金金 陈献亮[1] Shen Yanli;Li Jinjin;Chen Xianliang(Department of Respiratory Medicine,Henan Provincial People’s Hospital,Fuwai Central China Cardiovascular Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院阜外华中心血管病医院呼吸内科,郑州450003

出　　处：《中国实用医刊》2023年第23期5-9,共5页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210126)。

摘　　要：目的探讨碘125粒子植入联合程序性死亡受体-1阻断剂(PD-1单抗)加含铂化疗治疗晚期非小细胞肺癌(NSCLC)的有效性及安全性。方法抽取2019年10月至2021年10月阜外华中心血管病医院诊治的晚期NSCLC患者80例,按治疗方法不同分为对照组(40例,行PD-1单抗+含铂化疗)和研究组(40例,行碘125粒子植入+PD-1单抗+含铂化疗)。比较两组患者的客观缓解率(ORR)、疾病控制率(DCR),12、18个月生存率,血清细胞角蛋白片段19(CYFRA21-1)和癌胚抗原(CEA)水平以及不良反应发生率。结果研究组ORR高于对照组(P<0.05);两组DCR比较,差异未见统计学意义(P>0.05)。两组12个月生存率比较,差异未见统计学意义(P>0.05);但研究组18个月生存率高于对照组(P<0.05)。治疗后,两组血清CYFRA21-1及CEA水平均明显下降,且研究组下降更显著,差异均有统计学意义(P均<0.05)。研究组不良反应总发生率(15.00%,6/40)低于对照组(27.50%,11/40),但差异未见统计学意义(P>0.05)。结论碘125粒子植入联合PD-1单抗加含铂化疗作为一种新型治疗方法,在晚期NSCLC的治疗中表现出良好的疗效和安全性,为临床治疗提供了有益的补充选择。Objective To investigate the efficacy and safety of iodine-125 particle implantation combined with programmed death-1 blocker(PD-1 monoclonal antibody)and platinum-based chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC).Methods Eighty patients with advanced NSCLC who were diagnosed and treated in Fuwai Central China Cardiovascular Hospital from October 2019 to October 2021 were selected,and they were divided into control group(40 cases,treated by PD-1 monoclonal antibody and platinum-based chemotherapy)and study group(40 cases,treated by iodine-125 particle implantation combined with PD-1 monoclonal antibody and platinum-based chemotherapy)according to treatment methods.The objective response rate(ORR),disease control rate(DCR),12-and 18-month survival rates,level of serum cytokeratin fragment 19(CYFRA21-1),level of carcinoembryonic antigen(CEA),and incidence of adverse reactions were compared between the two groups.Results The ORR of the study group was significantly higher than that of the control group(P<0.05).There was no statistically significant difference in DCR between the two groups(P>0.05).There was no statistically significant difference in the 12-month survival rate between the two groups(P>0.05);but the 18-month survival rate of the study group was higher than that of the control group(P<0.05).After treatment,the levels of serum CYFRA21-1 and CEA in the two groups significantly decreased,and the decrease in the study group was more significant,compared with the control group(all P<0.05).The total incidence of adverse reactions in the study group(15.00%,6/40)was lower than that in the control group(27.50%,11/40),but the difference was not statistically significant(P>0.05).Conclusions Iodine-125 particle implantation combined with PD-1 monoclonal antibody and platinum-based chemotherapy as a new treatment strategy has shown good efficacy and safety in the treatment of advanced NSCLC,which can be a beneficial supplementary choice in clinical treatment.

关 键 词：非小细胞肺癌 晚期 碘125粒子植入放疗 程序性死亡受体-1 免疫治疗 

分 类 号：R734.2[医药卫生—肿瘤]