PD-1抗体免疫治疗联合GN方案治疗复发和转移鼻咽恶性肿瘤的效果  

Efficacy of PD-1 Antibody Immunotherapy Combined with GN Regimen in Treating Recurrent and Metastatic Malignant Tumors

作　　者：陈建光 CHEN Jianguang(Xianyou County General Hospital,Xianyou 351200,China)

机构地区：[1]仙游县总医院,福建仙游351200

出　　处：《中外医学研究》2024年第27期156-160,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：莆田市科技计划项目(2021S3001)。

摘　　要：目的:探究程序性细胞死亡受体1(PD-1)抗体免疫治疗联合吉西他滨联合长春瑞滨(GN)方案治疗复发和转移鼻咽恶性肿瘤的效果。方法:选取2015年1月—2021年1月在仙游县总医院就诊的60例复发和转移鼻咽恶性肿瘤患者作为研究对象,随机分为对照组和观察组,每组各30例。对照组行GN方案治疗,观察组则予以PD-1抗体免疫治疗联合GN方案,评价两组的近期疗效及治疗安全性,比较两组治疗前、治疗3个月后血管新生指标[内皮生长因子(VEGF)、胰岛素生长因子-1(IGF-1)、基质金属蛋白酶-9(MMP-9)]、外周血免疫指标[CD3^(+)、CD4^(+)/CD8^(+)、自然杀伤细胞(NK)]水平的差异性,对患者进行为期18个月的随访,绘制Kapan-Meier生存曲线统计患者的生存时间。结果:两组血管的临床疗效有效率分别为60.00%和83.33%,观察组较对照组更高,差异有统计学意义(P<0.05)。治疗3个月后,两组新生指标比较,观察组VEGF、IGF-1以及MMP-9均较对照组更低,差异有统计学意义(P<0.05)。治疗3个月后,两组外周血免疫指标比较,观察组CD3^(+)、CD4^(+)/CD8^(+)均高于对照组,其NK低于对照组,差异有统计学意义(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)。观察组生存时间较对照组更长,差异有统计学意义(P<0.05)。结论:PD-1抗体免疫治疗联合GN方案治疗复发和转移鼻咽恶性肿瘤疗效显著,可有效抑制患者肿瘤血管新生,改善其免疫功能,优化短期预后,安全系数较高。Objective:To investigate the efficacy of combination of programmed cell death receptor 1(PD-1)antibody immunotherapy and gemcitabine ombined with vinorelbine(GN)in the treatment of recurrent and metastatic nasopharyngeal malignant tumors.Method:A total of 60 patients with recurrent and metastatic nasopharyngeal malignant tumors were selected as the study objects from department of otolaryngology of Xianyou County General Hospital from January 2015 to January 2021,and they were randomly divided into control group and observation group,with 30 patients in each group.The control group received GN regimen treatment,while the observation group adopted PD-1 antibody immunotherapy combined with GN regimen.The short-term efficacy and treatment safety of the two groups were evaluated.The levels of angiogenesis indexes[endothelial growth factor(VEGF),insulin growth factor 1(IGF-1),matrix metalloproteinase-9(MMP-9)]and peripheral blood immune indexes[CD3^(+),CD4^(+)/CD8^(+),natural killer cells(NK)]were compared between the two groups before treatment and after 3 months of treatment.Patients were followed up for 18 months and Kapan-Meier survival curve was drawn to calculate the survival time of patients.Result:The clinical effective rates of the two groups were 60.00%and 83.33%,respectively.And the effective rate was higher in observation group(P<0.05).After 3 months of treatment,the angiogenesis indexs were compared,and VEGF,IGF-1 and MMP-9 in observation group were lower than those of control group(P<0.05).After 3 months^(+)of treatment,the peripheral blood immune indexes were compared.The CD3 and CD4^(+)/CD8^(+)levels in observation group were higher while the NK level was lower compared to control group(P<0.05).The incidence rates of various adverse reactions revealed no statistical differences between groups(P>0.05).The observation group had longer survival time than that the control group(P<0.05).Conclusion:PD-1 antibody immunotherapy combined with GN regimen is effective in the treatment of recurrent and metastatic

关 键 词：鼻咽恶性肿瘤 程序性细胞死亡受体1 吉西他滨 长春瑞滨 疗效 血管新生指标 

分 类 号：R739.63[医药卫生—肿瘤]