替雷利珠单抗治疗晚期胃癌的疗效和安全性分析  

Efficacy and safety analysis of tislelizumab in the treatment of advanced gastric cancer

作　　者：宋歌 高玉骞 罗爽 田晓玲 华云旗 Song Ge;Gao Yuqian;Luo Shuang;Tian Xiaoling;Hua Yunqi(Graduate School of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014000,China;Department of Digestive Oncology,Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou Cancer Hospital,Baotou 014000,China)

机构地区：[1]内蒙古科技大学包头医学院研究生学院,包头014000 [2]内蒙古科技大学包头医学院附属肿瘤医院、包头市肿瘤医院消化肿瘤内科,包头014000

出　　处：《中国医师进修杂志》2024年第9期846-851,共6页Chinese Journal of Postgraduates of Medicine

基　　金：2020年北京医学奖励基金会课题研究项目(YXJL-2020-0785-0396);2022年度包头市卫生健康科技计划(wsjkkj2022002);2022年“草原英才”工程专项资助(CYYC230416)。

摘　　要：目的分析替雷利珠单抗治疗晚期胃癌的疗效和安全性。方法回顾性分析包头市肿瘤医院2022年7月至2023年12月54例晚期胃癌患者的临床资料。其中,采用化学疗法治疗27例(对照组),替雷利珠单抗联合化学疗法治疗27例(联合组)。治疗2个周期后评价疗效。患者随访截至2024年3月,通过无进展生存期(PFS)和持续缓解时间(DOR)进行生存分析。记录不良反应。绘制Kaplan-Meier生存曲线,比较采用log-rank检验。采用二元Logistic回归分析影响晚期胃癌患者疗效的独立危险因素。结果联合组有效率和疾病控制率明显高于对照组[29.6%(8/27)比7.4%(2/27)和85.2%(23/27)比59.3%(16/27)],差异有统计学意义(χ^(2)=4.42和4.52,P<0.05)。Kaplan-Meier生存曲线分析结果显示,联合组中位PFS和DOR明显长于对照组(9.9个月比7.2个月和8.7个月比6.4个月),差异有统计学意义(log-rankχ^(2)=6.58和8.47,P<0.05)。54例患者中,有效10例(18.5%),无效44例(81.5%)。疗效与器官转移数量、前白蛋白和幽门螺杆菌感染率有关,差异有统计学意义(P<0.05)。二元Logistic回归分析结果显示,器官转移数量>1个、前白蛋白<160 mg/L和幽门螺杆菌感染是影响晚期胃癌患者疗效的独立危险因素(OR=0.089、8.418和0.153,95%CI 0.012~0.661、1.255~56.449和0.025~0.944,P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论晚期胃癌患者在化学疗法的基础上联合替雷利珠单抗治疗能提高疗效,延长生存期,且不增加不良反应发生率。Objective To analyze the efficacy and safety of tislelizumab in the treatment of advanced gastric cancer.Methods The clinical data of 54 patients with advanced gastric cancer in Baotou Cancer Hospital from July 2022 to December 2023 were retrospectively analyzed.Among them,27 patients were treated with chemotherapy(control group),and 27 patients were treated with tislelizumab combined with chemotherapy(combination group).The efficacy was evaluated after 2 cycles.The patients were followed up until March 2024,and the survival status was evaluated by progression-free survival(PFS)and duration of remission(DOR).The adverse reactions were recorded.Kaplan-Meier survival curve was drawn,and the compared used log rank test.Binary Logistic regression was used to analyze the independent risk factors of efficacy in patients with advanced gastric cancer.Results The effective rate and disease control rate in combined group were significantly higher than those in control group:29.6%(8/27)vs.7.4%(2/27)and 85.2%(23/27)vs.59.3%(16/27),and there were statistical differences(χ^(2)=4.42 and 4.52,P<0.05).Kaplan-Meier survival curve analysis result showed that the median PFS and DOR in combination group were significantly longer than those in control group(9.9 months vs.7.2 months and 8.7 months vs.6.4 months),and there were statistical differences(log-rank χ^(2)=6.58 and 8.47,P<0.05).Among the 54 patients,10 cases(18.5%)were effective,and 44 cases(81.5%)were ineffective.The efficacy was related to the number of organ metastase,prealbumin and Helicobacter pylori infection rate,and there were statistical differences(P<0.05).Binary Logistic regression analysis result showed that the number of organ metastase>1,prealbumin<160 mg/L and Helicobacter pylori infection were independent risk factors of efficacy in patients with advanced gastric cancer(OR=0.089,8.418 and 0.153;95%CI 0.012 to 0.661,1.255 to 56.449 and 0.025 to 0.944;P<0.05).There was no statistical difference in the incidence of adverse reactions between two groups(P>0.05).Co

关 键 词：胃肿瘤 免疫疗法 药物疗法 治疗结果 替雷利珠单抗 

分 类 号：R735.2[医药卫生—肿瘤]