化免治疗驱动基因阴性非小细胞肺癌寡转移病灶放疗介入时机初步分析  

A preliminary study on the timing of radiotherapy for chemoimmunotherapy in Oligometastatic Non-small-cell lung cancer with negative driver genes

作　　者：马影颖 彭杨 廖梓伊 曾丽 张宇 侯敏[1] 马代远[1] MA Ying-ying;PENG Yang;LIAO Zi-yi;ZENG Li;ZHANG Yu;HOU Min;MA Dai-yuan(Department of Oncology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院附属医院肿瘤科,四川南充637000

出　　处：《川北医学院学报》2024年第5期681-684,共4页Journal of North Sichuan Medical College

基　　金：川北医学院附属医院科研发展计划项目(2022LC009)。

摘　　要：目的:探索化疗联合免疫治疗驱动基因阴性非小细胞肺癌(NSCLC)寡转移病灶放疗的介入时机。方法:选取50例接受化疗联合免疫治疗驱动基因阴性NSCLC寡转移患者为研究对象,按照全身治疗时间不同分为早放疗组(全身治疗开始两个周期内寡转移灶接受放疗,n=24)和晚放疗组(全身治疗开始两个周期后寡转移灶接受放疗,n=26)。比较两组患者的临床疗效和不良反应发生情况。结果:早放疗组、晚放疗组疾病控制率分别为50.0%、26.9%,差异无统计学意义(P>0.05)。早放疗组中位无进展生存时间(PFS)为12.2个月长于晚放疗组的5.3个月(P<0.05);早放疗组中位总生存时间(OS)20.5个月,与晚放疗组的23.1个月比较,差异无统计学意义(P>0.05);治疗相关不良反应均可耐受,多为1~2级,两组毒性反应发生率无统计学差异(P>0.05)。结论:化免治疗NSCLC寡转移患者,转移灶早期介入放疗可延长PFS且不增加治疗相关不良反应。Objective:To evaluate the timing of radiotherapy for chemoimmunotherapy in Oligometastatic Non-small-cell lung cancer with negative driver genes.Methods:The clinical data of 50 patients with chemoimmunotherapy in Oligometastatic Non-small-cell lung cancer with negative driver genes were selected as the research subjects.They were divided into early radiotherapy group(≤2 cycles of mmunotherapy,n=24)and deferred radiotherapy group(>2 cycles of immunotherapy,n=26)according to the different duration of systemic treatment.The clinical efficacy and adverse reactions were compared between the two groups.Results:The tumor control rates in the early radiotherapy group and the deferred radiotherapy group were 50.0%and 26.9%,respectively,with no statistically significant difference(P>0.05).The progression free survival(PFS)in early radiotherapy group was longer than that in the deferred radiotherapy group(12.2months vs.5.3months,P<0.05).The overall survival time(OS)in two groups were no significance(20.5 months vs.23.1 months,P>0.05).Adverse reactions related to treatment were tolerable,mostly ranging from grade 1~2.There was no statistically significant difference in the incidence of toxic reactions between the two groups(P>0.05).Conclusion:The study suggests that early initiation of local radiotherapy for chemoimmunotherapy in negative driver genes NSCLC patients with oligometastasis resulted in better PFS and do not result more adverse reactions.

关 键 词：非小细胞肺癌 寡转移 免疫治疗 放疗 最佳时间 

分 类 号：R734.2[医药卫生—肿瘤]