调强适形放疗联合PD-1/PD-L1抑制剂治疗中晚期直肠癌的临床研究  

Intensity Modulated Conformal Radiotherapy Combined with PD-1/PD-L1 Inhibitors in Treatment of Advanced Rectal Cancer

作　　者：张辉[1] 赵凯杰[1] 刘文举 ZHANG Hui;ZHAO Kai-jie;LIU Wen-ju(Radiotherapy Room of Cancer Center,Henan Provincial People's Hospital,Zhengzhou,Henan 45oo03)

机构地区：[1]河南省人民医院肿瘤中心放疗机房,河南郑州450003

出　　处：《中国肛肠病杂志》2024年第8期19-21,共3页Chinese Journal of Coloproctology

摘　　要：目的:观察调强适形放疗联合程序性死亡受体1(PD-1)/程序性死亡受体-配体1(PD-L1)抑制剂治疗中晚期直肠癌的疗效及不良反应。方法:回顾2018年1月至2020年6月接受调强适形放疗的82例中晚期直肠癌患者资料,其中单纯调强适形放疗33例(简称单纯放疗组),调强适形放疗联合PD-1/PD-L1抑制剂治疗49例(简称联合治疗组)。比较2组近、远期疗效,治疗前后肿瘤M2丙酮酸激酶(TuM2-PK)和脂肪酸合成酶(FAS)水平,以及不良反应。结果:联合治疗组治疗总有效率(ORR)及疾病控制率(DCR)分别为32.65%、83.67%,均高于单纯放疗组(21.21%、72.73%),P<0.05。联合治疗组1、2、3年生存率分别为89.80%、73.47%、57.14%,单纯放疗组为72.73%、51.52%、42.42%。联合治疗组1、2、3年生存率均高于单纯放疗组,P<0.05。随访至2024年4月30日,联合治疗组平均生存时间为(35.93±8.22)月,单纯放疗组为(29.13±6.57)月,联合治疗组平均生存时间明显长于单纯放疗组,P<0.05。2组胃肠道反应、骨髓抑制、肝肾功能损伤、放射性皮炎等不良反应发生率比较差异均无统计学意义,P>0.05。结论:调强适形放疗联合PD-1/PD-L1抑制剂治疗中晚期直肠癌可提高近远期疗效,且不增加不良反应。Objective To observe the efficacy and adverse reactions of intensity modulated conformal radiotherapy combined with programmed death receptor-1(PD-1)/programmed death receptor-ligand 1(PD-L1)inhibitors in the treatment of middle and advanced rectal cancer.Methods Data of 82 patients with advanced rectal cancer who received intensity modulated conformal radiotherapy from January 2018 to June 2020 were reviewed,including 33 patients receiving intensity modulated conformal radiotherapy alone(mere radiotherapy group for short)and 49 patients receiving intensity modulated conformal radiotherapy combined with PD-1/PD-L1 inhibitors(combined treatment group for short).The short and long term efficacy,levels of tumor M2 pyruvate kinase(TuM2-PK)and fatty acid synthetase(FAS)before and after treatment,and adverse reactions were compared between the two groups.Results The overall response rate(ORR)and disease control rate(DCR)of the combined treatment group were 32.65% and 83.67%,respectively,which were higher than those of the mere radiotherapy group(21.21%and 72.73%)(P<0.05).The 1-year,2-year and 3-year survival rates in the combined treatment group were 89.80%,73.47% and 57.14%,respectively,which were higher than those in the mere radiotherapy group(72.73%,51.52% and 42.42%)(P<0.05).Follow-up to April 30,2024,the mean survival time of the combined treatment group was(35.93±8.22)months,which was significantly longer than(29.13±6.57)months in the mere radiotherapy group,(P<0.05).There was no significant difference in the incidence of gastrointestinal reactions,myelosuppression,liver and kidney function damage and radiation dermatitis between the two groups(P>0.05).Conclusion Intensity modulated conformal radiotherapy combined with PD-1/PD-L1 inhibitors can improve the short and long term therapeutic effect in the treatment of middle and advanced rectal cancer without increasing adverse reactions.

关 键 词：调强适形放疗 PD-1/PD-L1抑制剂 疗效 生存时间 不良反应 

分 类 号：R735.37[医药卫生—肿瘤]