免疫检查点抑制剂治疗广泛期小细胞肺癌的疗效及发生甲状腺功能紊乱风险的Meta分析  

Meta-analysis of the Efficacy of Immune Checkpoint Inhibitors in the Treatment of Extensive-disease Small-Cell Lung Cancer and Risk of Thyroid Dysfunction

作　　者：王延玲 李晶[2] 孙静[1] 杨小璇 巩平[1,3] Wang Yanling;Li Jing;Sun Jing(Shihezi University School of Medicine,Shihezi,Xinjiang,832000,China)

机构地区：[1]石河子大学医学院,新疆石河子832000 [2]石河子大学第一附属医院肿瘤科,新疆石河子832000 [3]石河子大学第三附属医院肿瘤科,新疆石河子832000

出　　处：《黑龙江医学》2025年第2期131-135,共5页Heilongjiang Medical Journal

基　　金：石河子大学青年创新人才计划(CXPY202319)。

摘　　要：目的:评估免疫检查点抑制剂(ICIs)治疗广泛期小细胞肺癌(ED-SCLC)的疗效及发生免疫相关性甲状腺功能紊乱(ir-TD)的风险。方法:系统检索并分析PubMed、Embase、Cochrane Library、Web of Science和Scopus 5个数据库截至2023年8月所有关于ICIs治疗ED-SCLC的相关研究。结果:通过筛选951篇相关文献,最终有6项研究共2995例患者被纳入Meta分析。与对照组相比,ICIs治疗能显著延长患者的总生存期(HR:0.74,95%CI:0.68~0.81,P<0.001)及无进展生存期(HR:0.68,95%CI:0.60~0.78,P<0.001),客观缓解率(ORR)(RR:1.11,95%CI:1.01~1.23,P=0.03)也优于对照组。然而,ICIs治疗明显增加了甲状腺功能减退(RR:5.80,95%CI:2.18~15.44,P=0.0004)和甲状腺功能亢进(RR:2.76,95%CI:1.76~4.32,P<0.001)的发生风险。结论:ICIs治疗ED-SCLC能明显改善患者预后,延长患者生存期,整体安全性良好,但增加了ir-TD的发生风险。Objective:To elevate the efficacy and development of immune-related Thyroid Dysfunction(ir-TD)in the treatment of extensive-disease small-cell lung cancer(ED-SCLC)with immune checkpoint inhibitors(ICIs).Methods:Studies on the treatment of ED-SCLC by ICIs from data set to August 2023 were searched from the PubMed,Embase,Cochrane Library,Web of Science and Scopus databases were included and analyzed in this studies.Results:6 studies with a total of 2995 patients were selected from 951 articles and included in Meta-analysis.Compared with the control group,ICIs treatment significantly prolonged overall survival(HR:0.74,95%CI:0.68~0.81,P<0.001)and progression free survival(HR:0.68,95%CI:0.60~0.78,P<0.001),and the ORR(RR:1.11,95%CI:1.01~1.23,P=0.03)was also superior to that of the control group.However,treatment with ICIs significantly increased the risk of hypothyroidism(RR:5.80,95%CI:2.18~15.44,P=0.0004)and hyperthyroidism(RR:2.76,95%CI:1.76~4.32,P<0.001).Conclusion:ICIs can significantly improve the prognosis and prolong the survival of ED-SCLC patients,with a high safety,but it increases the risk of ir-TD.

关 键 词：免疫检查点抑制剂 疗效 甲状腺功能紊乱 小细胞肺癌 META分析 

分 类 号：R73[医药卫生—肿瘤]