新辅助化疗联合免疫抑制剂对Ⅲ期非小细胞肺癌治疗有效性分析  

Efficacy of neoadjuvant chemotherapy combined with immunotherapy in the treatment of stageⅢnon-small cell lung cancer

作　　者：王居巳 宋伟安[1] 狄守印 刘军强 范博士 周少华 岳彩迎 赵嘉华[1] 陈思禹[1] 龚太乾 Wang Jusi;Song Weian;Di Shouyin;Liu Junqiang;Fan Boshi;Zhou Shaohua;Yue Caiying;Zhao Jiahua;Chen Siyu;Gong Taiqian(Department of Thoracic Surgery,the Sixth Medical Center of PLA General Hospital,Beijing 100037,China)

机构地区：[1]解放军总医院第六医学中心胸外科,北京100037

出　　处：《首都医科大学学报》2024年第4期660-665,共6页Journal of Capital Medical University

基　　金：北京市科学技术委员会“首都临床特色”项目支持(Z161100000516185)。

摘　　要：目的探讨新辅助化学药物治疗(以下简称化疗)联合免疫抑制剂对Ⅲ期非小细胞肺癌的短期治疗效果及安全性。方法选取2021年1月至2024年2月解放军总医院第六医学中心的Ⅲ期非小细胞肺癌患者53例,均行新辅助化疗联合免疫治疗,以21 d为一个周期,治疗中评估安全性及治疗结束时评估疗效。结果影像学评估显示,完全缓解8例,部分缓解34例,疾病稳定8例,疾病进展3例,客观缓解率为79.2%,疾病控制率为94.3%。新辅助治疗后经影像学评估及科室讨论后53例患者均实施微创胸腔镜肿瘤切除术,无中转开胸患者,术后并发症10例,发生率18.7%,1例患者术后出现严重肺部感染致呼吸衰竭死亡。术后组织病理学评估显示,完全缓解15例、部分缓解32例、疾病稳定5例、疾病进展1例,主要病理缓解33例(62.3%),客观缓解率为88.7%,疾病控制率98.1%。不良反应主要为1、2级,仅出现3例3级不良事件,无4级不良反应。结论新辅助化疗联合免疫治疗对于局部晚期非小细胞肺癌具有较好的疗效及安全性,值得进一步推广应用。Objective To investigate the short-term efficacy and safety of neoadjuvant chemotherapy combined with immunosuppressants in the treatment of stage non-small cell lung cancer.Methods Totally 53 patients with stageⅢnon-small cell lung cancer in the Sixth Medical Center of the General Hospital from January 2021 to February 2024 were selected to assess the safety during treatment and the efficacy at the end of treatment.Results The imaging evaluation showed that 8 patients had complete response,34 patients had partial response,8 patients had stable disease,and 3 patients had progressive disease.The objective remission rate was 79.2%,and the disease control rate was 94.3%.After neoadjuvant therapy,all 53 patients underwent minimally invasive thoracoscopic tumor resection after imaging and department discussion,and no patients converted to thoracotomy,10 patients had postoperative complications,with the incidence of 18.7%,and only 1 patient died of respiratory failure caused by severe pulmonary infection after surgery.Histopathological evaluation showed that there were 15 cases of complete response,32 cases of partial response,5 cases of stable disease,1 case of disease progression,and 33 cases(62.3%)of the major pathological response,with the objective response rate of 88.7%and the disease control rate of 98.1%.The adverse reactions were mainly grade 1 and 2,and only 3 patients of grade 3 adverse events,and no grade 4 adverse reactions occurred.Conclusion Neoadjuvant immunotherapy combined with chemotherapy has good efficacy and safety in the treatment of locally advanced non-small cell lung cancer,and is worthy of further promotion and application.

关 键 词：非小细胞肺癌 新辅助治疗 免疫治疗 疗效 安全性 

分 类 号：R734.2[医药卫生—肿瘤]