放疗联合帕博利珠单抗治疗晚期非小细胞肺癌的临床效果  

SBRT Combined with Pabolizumab in Advanced Non-Small Cell Lung Cancer

作　　者：陈泓羽 李铁莲[1] 杨蕾[1] 谢玲 CHEN Hong-yu;LI Tie-lian;YANG Lei;XIE Ling(Department of Oncology,Panzhihua City Hospital of Integrated Traditional Chinese and Western Medicine/the Affiliated Hospital of Panzhihua University,Panzhihua 617000,China)

机构地区：[1]攀枝花市中西医结合医院(攀枝花学院附属医院)肿瘤科,四川攀枝花617000

出　　处：《南昌大学学报（医学版）》2024年第3期78-82,88,共6页Journal of Nanchang University：Medical Sciences

基　　金：四川省卫生健康科研基金项目(20210196)。

摘　　要：目的 探究立体定向体放射治疗(SBRT)联合帕博利珠单抗对晚期非小细胞肺癌(NSCLC)患者生存和肿瘤反应影响。方法 对2019—2020年期间在攀枝花市中西医结合医院接受一线帕博利珠单抗化疗的NSCLC患者病历进行回顾性分析,共纳入符合标准的患者116例,共有32.8%(38/116)的患者接受了SBRT,纳入联合组,其余患者纳入单用组。使用Kaplan-Meier模型评估2组中位无进展生存期(PFS)和总生存期(OS)。记录比较2组的不良反应发生情况。结果 整个队列的中位PFS为12.00个月(95%CI:10.17~13.83),和中位OS为23.43个月(95%CI:20.04~26.82)。多变量分析显示,SBRT治疗是PFS(HR:0.45,95%CI:0.65~0.93,P=0.020)和OS(HR:0.32,95%CI:0.53~0.87,P=0.013)的独立预测因素。联合组的中位PFS为13.97个月(95%CI:12.04~15.89),而单用组为10.08个月(95%CI:7.90~12.27)(P=0.016)。联合组的中位OS为30.67个月(95%CI:22.20~39.14),而单用组为21.97个月(95%CI:18.64~25.30)(P=0.011)。2组间总体不良事件发生率比较差异无统计学意义(P>0.05),联合组3级或3级以上肺炎的发生率略高于单用组(7.89%vs 3.87%),但差异无统计学意义(P=0.350)。结论 在一线帕博利珠单抗治疗期间,联合SBRT可改善晚期NSCLC患者的PFS和OS,且不增加治疗毒性。Objective To investigate the effect of stereotactic body radiotherapy(SBRT)combined with pabolizumab on the survival and tumor response in patients with advanced non-small cell lung cancer(NSCLC).Methods The medical records of NSCLC patients who received pabolizumab chemotherapy at our hospital from 2019 to 2020 were retrospectively analyzed,and a total of 116 patients who met the criteria were included;a total of 32.8%(38/116)of the patients received SBRT and were established as the combination group,and the remaining patients were categorized as the monotherapy group.The median progression-free survival(PFS)and overall survival(OS)of the 2 groups were assessed using the Kaplan-Meier model.The occurrence of adverse reactions in the 2 groups was recorded and compared.Results The median PFS for the entire cohort was 12.00 months(95%CI:10.17 to 13.83),and the median OS was 23.43 months(95%CI:20.04 to 26.82).Multivariate analysis showed that SBRT was an independent predictor of PFS(HR:0.45,95%CI:0.65-0.93,P=0.020)and OS(HR:0.32,95%CI:0.53-0.87,P=0.013).The median PFS was 13.97 months(95%CI:12.04-15.89)in the combination group compared with 10.08 months(95%CI:7.90-12.27)in the monotherapy group(P=0.016);the median OS was 30.67 months(95%CI:22.20-39.14)in the combination group compared with 21.97 months(95%CI:18.64-25.30)in the monotherapy group(P=0.011).The difference in overall adverse event rates in the 2 groups was not statistically significant(P>0.05);the incidence of grade 3 or higher pneumonia was slightly higher in the combination group than in the monotherapy group(7.89%vs.3.87%),but the difference was not statistically significant(P=0.350).Conclusion SBRT combined with pabolizumab could improve PFS and OS in patients with advanced NSCLC without increasing treatment toxicity.

关 键 词：立体定向体放射治疗 帕博利珠单抗 晚期非小细胞肺癌 肿瘤反应 

分 类 号：R734.2[医药卫生—肿瘤]