不同化疗方案联合信迪利单抗一线治疗晚期胃癌的临床疗效及安全性  

Clinical efficacy and safety of different chemotherapeutic regimens combined with sintilimab as first-line treatment for advanced gastric cancer

作　　者：徐丹颖 倪文豪 黄若冰 王红兵 XU Danying;NI Wenhao;HUANG Ruobing;WANG Hongbing(Oncology Department,Xuzhou Medical University,Xuzhou 221000;Oncology Department,The Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学肿瘤科,江苏徐州221000 [2]徐州医科大学附属医院肿瘤科,江苏徐州221000

出　　处：《西安交通大学学报（医学版）》2024年第6期960-966,共7页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：目的 评估不同的化疗方案联合信迪利单抗一线治疗Her-2阴性晚期胃癌的临床疗效和安全性。方法 分别回顾性收集2021年9月1日至2023年7月1日于徐州医科大学附属医院接受白蛋白结合型紫杉醇、替吉奥联合信迪利单抗一线治疗Her-2阴性晚期胃癌患者的临床资料共计40例,接受奥沙利铂、替吉奥联合信迪利单抗一线治疗Her-2阴性晚期胃癌患者的临床资料共计36例。评估两组患者治疗的临床疗效及不良反应发生情况。对两组的临床资料分别进行因素分析。结果 白蛋白结合型紫杉醇组客观缓解率(objective response rate, ORR)为57.5%,奥沙利铂组的ORR为52.8%。白蛋白结合型紫杉醇组的疾病控制率(disease control rate, DCR)为85.0%,奥沙利铂组的DCR为80.6%。白蛋白结合型紫杉醇组与奥沙利铂组患者的中位无进展生存期(median progression-free survival, mPFS)分别为8.3个月、9.0个月。白蛋白结合型紫杉醇组的不良反应发生率为87.5%(35/40例),奥沙利铂组为91.7%(33/36例)。对两组患者的临床资料分别进行因素分析,肝转移是影响白蛋白结合型紫杉醇组和奥沙利铂组Her-2阴性晚期胃癌患者PFS的独立危险因素。结论 白蛋白结合型紫杉醇、替吉奥联合信迪利单抗与奥沙利铂、替吉奥联合信迪利单抗一线治疗Her-2阴性晚期胃癌均有良好的疗效,不良反应可控。Objective To evaluate the clinical efficacy and safety of different chemotherapeutic regimens combined with sintilimab as first-line treatment for Her-2 negative advanced gastric cancer.Methods We retrospectively collected the clinical data of patients with Her-2 negative advanced gastric cancer treated with albumin-bound paclitaxel plus S-1 combined with sintilimab(n=40)and oxaliplatin plus S-1 combined with sintilimab(n=36)at The Affiliated Hospital of Xuzhou Medical University from September 1,2021 to July 1,2023.The clinical efficacy and adverse reactions were evaluated separately in patients treated with albumin-bound paclitaxel plus S-1 combined with sintilimab and in those treated with oxaliplatin plus S-1 combined with sintilimab.Factor analysis was made on two sets of clinical data separately.Results The objective response rate(ORR)of albumin-bound paclitaxel group and oxaliplatin group was 57.5%and 52.8%,respectively.The disease control rate(DCR)of albumin-bound paclitaxel group and oxaliplatin group was 85.0%and 80.6%,respectively.The median progression-free survival(PFS)of patients in albumin-bound paclitaxel group and oxaliplatin group was 8.3 months and 9.0 months.The incidence of adverse reactions in albumin-bound paclitaxe group was 87.5%(35/40),and that in the oxaliplatin group was 91.7%(33/36).Factor analysis of the clinical data of albumin-bound paclitaxel group and oxaliplatin group revealed that liver metastasis was an independent risk factor for PFS.Conclusion Both albumin-bound paclitaxel combined with S-1 and sintilimab,and oxaliplatin combined with S-1 and sintilimab show promising efficacy and manageable side effects when used as first-line treatment for Her-2 negative advanced gastric cancer.

关 键 词：免疫治疗 信迪利单抗 白蛋白结合型紫杉醇 晚期胃癌 替吉奥 

分 类 号：R735.2[医药卫生—肿瘤]