基于倾向性评分匹配的肺腺癌二线化疗联合贝伐珠单抗或免疫检查点抑制剂的回顾性研究  

A retrospective study of second-line chemotherapy combined with bevacizumab or immune checkpoint inhibitors based on propensity score matching for lung adenocarcinoma

作　　者：王淑伟 林亚南 邵姜超 齐越[1] 杜佳倩 丛秋梅 马晓华[1] 张国英[4] Wang Shuwei;Lin Ya′nan;Shao Jiangchao;Qi Yue;Du Jiaqian;Cong Qiumei;Ma Xiaohua;Zhang Guoying(Tumor Medical Center,Weihai Municipal Hospital,Cheeloo College of Medicine,Shandong University,Weihai 264200,China;Department of Science and Education,Weihai Municipal Hospital,Cheeloo College of Medicine,Shandong University,Weihai 264200,China;First Department of Oncology,Weihai Central Hospital,Weihai 264400,China;Weihai City Center for Disease Control,Weihai 264200,China)

机构地区：[1]山东大学附属威海市立医院肿瘤医学中心,威海264200 [2]山东大学附属威海市立医院科教科,威海264200 [3]威海市中心医院肿瘤一科,威海264400 [4]威海市疾病预防控制中心,威海264200

出　　处：《中华转移性肿瘤杂志》2024年第6期573-579,共7页Chinese Journal of Metastatic Cancer

摘　　要：目的比较肺腺癌二线化疗联合贝伐珠单抗或免疫检查点抑制剂的有效性与安全性。方法回顾性分析2019年1月1日至2021年6月30日山东大学附属威海市立医院和威海市中心医院收治的93例二线化疗联合贝伐珠单抗或免疫检查点抑制剂治疗的肺腺癌患者病历资料,通过倾向性评分匹配,28对配对成功(贝伐珠单抗组和免疫检查点抑制剂组)。采用χ^(2)检验进行临床特征、近期疗效及不良反应比较。Kaplan-Meier法生存分析,Cox模型多因素预后分析。结果倾向性评分匹配后全组2年总生存(OS)率为43.9%,2年无进展生存(PFS)率为32.5%。贝伐珠单抗组客观缓解率(ORR)为35.7%、疾病控制率(DCR)为96.4%,免疫检查点抑制剂组分别为39.3%、75.0%(P=0.783、P=0.051)。贝伐珠单抗组2年OS率为54.1%,PFS率为39.9%,免疫检查点抑制剂组分别为34.6%、29.2%(P=0.211、P=0.419)。贝伐珠单抗组与免疫检查点抑制剂组的不良反应发生率分别为35.7%与21.4%(P>0.05)。多因素分析显示未脑转移是PFS(HR=0.355,P=0.005)和OS(HR=0.363,P=0.005)独立保护因素。结论肺腺癌二线化疗联合贝伐珠单抗和免疫检查点抑制剂有效性相当、安全性一致,贝伐珠单抗可作为新的选择。Objective To compare the efficacy and safety of second-line chemotherapy combined with bevacizumab or immune checkpoint inhibitors for lung adenocarcinoma.Methods A retrospective analysis was performed on the medical records of 93 patients with lung adenocarcinoma receiving second-line chemotherapy combined with bevacizumab or immune checkpoint inhibitors in Weihai Municipal Hospital and Weihai Central Hospital from January 1,2019 to January 30,2021.Through propensity score matching,28 pairs were successfully matched(bevacizumab group and immune checkpoint inhibitors group).χ^(2)test was used for comparison of clinical characteristics,short-term efficacy and adverse reactions between bevacizumab group and immune checkpoint inhibitors group.Kaplan-Meier method was used for survival analysis.Cox model was used for multivariate prognostic analysis.Results After propensity score matching,the 2-year overall survival(OS)and progression free survival(PFS)were 43.9%and 32.5%,respectively in the groups.The objective response rate(ORR)and disease control rate(DCR)were 35.7%and 96.4%respectively in the bevacizumab group,and 39.3%and 75.0%respectively in the immune checkpoint inhibitors group(P=0.783,P=0.051).The 2-year OS and PFS were 54.1%and 39.9%respectively in the bevacizumab group,and 34.6%and 29.2%respectively in the immune checkpoint inhibitors group(P=0.211,P=0.419).The incidence of adverse reactions was 35.7%in the bevacizumab group and 21.4%in the immune checkpoint inhibitors group(P>0.05).Conclusion Second-line chemotherapy combined with bevacizumab and with immune checkpoint inhibitors show the same efficacy and safety for lung adenocarcinoma,and bevacizumab can be a new choice.

关 键 词：肺腺癌 贝伐珠单抗 免疫检查点抑制剂 倾向性评分匹配 不良反应 

分 类 号：R73[医药卫生—肿瘤]