新辅助免疫治疗联合化疗在局部晚期喉癌及下咽癌中的效果分析  

Efficacy analysis of neoadjuvant immunotherapy combined with chemotherapy in patients with locally advanced laryngeal cancer and hypopharyngeal cancer

作　　者：金玲爽[1] 吴雨雷[1] 张文斌[2] 王晶[3] 杨立[4] Jin Lingshuang;Wu Yulei;Zhang Wenbin;Wang Jing;Yang Li(Department of Head and Neck Surgery,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Endoscopy,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Pathology,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Color Ultrasound Room,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院、中国医学科学院肿瘤医院、山西医院山西医科大学附属肿瘤医院头颈外科,太原030013 [2]山西省肿瘤医院、中国医学科学院肿瘤医院、山西医院山西医科大学附属肿瘤医院内镜室,太原030013 [3]山西省肿瘤医院、中国医学科学院肿瘤医院、山西医院山西医科大学附属肿瘤医院病理科,太原030013 [4]山西省肿瘤医院、中国医学科学院肿瘤医院、山西医院山西医科大学附属肿瘤医院彩超室,太原030013

出　　处：《肿瘤研究与临床》2024年第4期275-278,共4页Cancer Research and Clinic

摘　　要：目的探讨新辅助免疫治疗联合化疗在局部晚期喉癌及下咽癌中的效果。方法回顾性病例系列研究。回顾性分析2020年6月至2022年6月山西省肿瘤医院16例局部晚期喉癌和下咽癌患者的临床资料。所有患者术前予以新辅助程序性死亡受体1(PD-1)抑制剂(特瑞普利单抗240 mg,临床试验号:IIT-2023-142H)+纳米颗粒白蛋白结合紫杉醇(260 mg/m^(2))+顺铂(60 mg/m^(2))治疗,2~3个周期后行保留喉功能的手术,术后予以低剂量放疗50 Gy。观察患者临床疗效、不良反应、喉功能保留率及并发症。所有数据使用SPSS25.0软件进行统计学分析。结果16例患者年龄[M(Q1,Q3)]63岁(55岁,76岁),男性13例,女性3例。新辅助治疗后,所有患者瘤体不同程度缩小,其中1例(6.3%)完全缓解,13例(81.3%)部分缓解,2例(12.5%)病情稳定,总缓解率为87.5%(14/16)。14例(87.5%)患者达到临床T降期,成功实施喉功能保留手术,喉功能保留率为87.5%。16例患者新辅助治疗后不良反应除1例3级贫血外,其他均为1~2级。未观察到与免疫治疗相关的不良反应。16例患者均顺利完成手术,术后并发症为伤口感染2例,咽瘘、乳糜漏、淋巴漏各1例,所有伤口经过换药处理达到一期愈合。结论新辅助免疫疗法联合化疗治疗局部晚期喉癌及下咽癌可有较好疗效,能使喉功能得到保留,且安全性良好。Objective To explore the clinical effect of neoadjuvant immunotherapy combined with chemotherapy in patients with locally advanced laryngeal and hypopharyngeal carcinoma.Methods A retrospective case series study was conducted.The clinical data of 16 patients with locally advanced laryngeal and hypopharyngeal cancer in Shanxi Province Cancer Hospital from June 2020 to June 2022 were retrospectively analyzed.Before surgery,all patients received neoadjuvant programmed-death receptor 1(PD-1)inhibitor treatment therapy including 240mg terprilizumab(clinical trial number:IIT-2023-142H),260 mg/m^(2) nanoparticle albumin combined with paclitaxel and 60 mg/m^(2) cisplatin.After 2-3 cycles,laryngeal function retention surgery was planned and postoperative low-dose radiotherapy was given to 50Gy.The clinical efficacy,adverse reactions,laryngeal function retention rate and complications were observed.All data were statistically analyzed with SPSS25.0 software.Results The age[M(Q_(1),Q_(3))]of 16 patients was 63 years(55 years,76 years),13 males and 3 females.After neoadjuvant therapy,the tumor size was reduced at different degree.Among 16 patients,1 case(6.3%)achieved complete remission;13 cases(81.3%)achieved partial remission;2 cases(12.5%)showed stable disease,and the overall response rate was 87.5%(14/16).And 14 patients(87.5%)reached the clinical T-decline stage and successfully underwent laryngeal function retention surgery,and the rate of laryngeal function retention was 87.5%.All treatment-related adverse reactions of 16 patients were grade 1-2 after neoadjuvant immunotherapy except 1 patient with grade 3 anemia.No adverse effects related to immunotherapy were observed.All the 16 patients successfully underwent surgery.Postoperative complications included wound infection in 2 cases,pharyngeal fistula in 1 case,chylorrhea in 1 case,and lymphatic leakage in 1 case.All wounds were healed primarily by dressing change.Conclusions Neoadjuvant immunotherapy combined with chemotherapy for locally advanced laryngeal cancer an

关 键 词：喉肿瘤 下咽肿瘤 免疫疗法 药物疗法 联合 

分 类 号：R739.65[医药卫生—肿瘤]