机构地区:[1]东部战区总医院秦淮医疗区呼吸内科,江苏南京620002 [2]东部战区总医院秦淮医疗区体检中心,江苏南京620002
出 处:《河北医科大学学报》2024年第12期1394-1398,共5页Journal of Hebei Medical University
基 金:江苏省科技计划项目(面上基金项目)(BE2019719)。
摘 要:目的探究卡瑞利珠单抗联合吉西他滨+顺铂化疗在晚期肺鳞癌患者中的治疗效果。方法将82例晚期肺鳞癌患者根据治疗方案分为2组,其中对照组38例,予以吉西他滨+顺铂化疗,观察组44例,在对照组基础上联合卡瑞利珠单抗治疗。治疗2个周期后,评价2组的短期疗效、药物毒性反应、肿瘤标志物表达[鳞状细胞癌抗原(squamous cell carcinoma antigen,SCC-Ag)、角蛋白19片段抗原(cytokeratin 19 fragment antigen,CYFRA)21-1、甲状腺转录因子1(thyroid transcription factor-1,TTF-1)],随访12个月,记录患者的中位生存率(overall survival,OS)和中位无进展生存期(progression-free survival,PFS)。结果观察组的客观缓解率为29.55%,高于对照组10.53%;疾病控制率为77.27%,高于对照组52.63%(P<0.05)。治疗后,2组的血清SCC-Ag、CYFRA21-1较治疗前均降低,观察组低于对照组(P<0.05);2组治疗后的TTF-1水平比较差异无统计学意义(P>0.05)。2组的骨髓抑制、消化道反应、肝功能异常、皮肤黏膜毒性、过敏反应、神经系统毒性发生率比较差异无统计学意义(P<0.05)。观察组和对照组的中位PFS分别4个月、3个月,中位OS分别为11个月、7个月。2组的PFS和OS生存曲线比较差异均有统计学意义(Log-rankχ^(2)=9.937、12.471,P<0.05)。结论卡瑞利珠单抗联合吉西他滨+顺铂化疗治疗晚期肺鳞癌,有助于提升患者的抗肿瘤效果,调节肿瘤相关生物学标志物的表达,安全性良好。Objective To explore the efficacy of carilizumab combined with gemcitabine and cisplatin chemotherapy in patients with advanced lung squamous cell carcinoma(LSCC).Methods In total,82 patients with advanced LSCC were divided into two groups according to the treatment plan.The control group consisted of 38 patients who received gemcitabine and cisplatin chemotherapy,while the observation group consisted of 44 patients who received treatment with combination therapy of carizolizumab on the basis of the control group.After 2 cycles of treatment,the short-term efficacy,drug toxicity,and tumor marker expression[squamous cell carcinoma antigen(SCC Ag),cytokeratin 19 fragment antigen(CYFRA)21-1,thyroid transcription factor-1(TTF-1)]of both groups were evaluated.They were followed up for 12 months,and the median overall survival(OS)and progression-free survival(PFS)of the patients were recorded.Results The objective remission rate of the observation group was 29.55%,which was higher than that of the control group(10.53%),and the disease control rate was 77.27%,which was higher than that of the control group(52.63%)(P<0.05).After treatment,the serum levels of SCC Ag and CYFRA21-1 in both groups decreased compared with those before treatment,which were lower in the observation group than in the control group(P<0.05).There was no significant difference in TTF-1 levels between the two groups after treatment(P>0.05).There was no significant difference in the incidence of bone marrow suppression,gastrointestinal reactions,liver dysfunction,skin and mucosal toxicity,allergic reactions,and neurological toxicity between the two groups(P<0.05).The median PFS of the observation group and the control group were 4 months and 3 months,respectively,and the median OS was 11 months and 7 months,respectively.The difference in PFS and OS survival curves between the two groups was statistically significant(Log rankχ^(2)=9.937,12.471,P<0.05).Conclusion The combination of carilizumab and gemcitabine+cisplatin chemotherapy for advanced LSCC ca
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