帕博利珠单抗联合调强放疗对HER2阳性乳腺癌患者免疫功能及预后的影响  

Effect of Pabolizumab Combined with Intensity Modulated Radiotherapy on Immune Function and Prognosis of HER2 Positive Breast Cancer Patients

作　　者：郑晓娜 王磊 胡应亮 徐慧 李慧 ZHENG Xiaona;WANG Lei;HU Yingliang;XU Hui;LI Hui(Radiotherapy Department,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China)

机构地区：[1]郑州大学附属郑州中心医院放疗科,河南郑州450007

出　　处：《河南医学研究》2025年第6期1017-1020,共4页Henan Medical Research

基　　金：河南省科技攻关项目(232102310116)。

摘　　要：目的探讨帕博利珠单抗联合调强放射治疗(IMRT)对人表皮生长因子受体2(HER2)阳性乳腺癌患者免疫功能及预后的影响。方法纳入郑州大学附属郑州中心医院的128例HER2阳性乳腺癌患者(2021年1月至2023年6月)临床资料,通过回顾性研究方法,按术后治疗方案将其分为研究组(64例)和对照组(64例)。研究组行帕博利珠单抗联合IMRT放疗,对照组行帕博利珠单抗单药治疗。比较两组患者的临床疗效[客观缓解率(ORR)、疾病控制率(DCR)]、免疫功能(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)),随访1 a,比较两组治疗1 a后的总体生存率。结果两组ORR对比,差异无统计学意义(P>0.05);研究组DCR[79.69%(51/64)]高于对照组[62.50%(40/64)](P<0.05);治疗前两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)对比差异无统计学意义(P>0.05);单药治疗4个周期后,研究组患者CD3^(+)、CD4^(+)高于对照组,CD4^(+)/CD8^(+)低于对照组(P<0.05);与治疗前相比,治疗后两组CD3^(+)、CD4^(+)均升高,CD4^(+)/CD8^(+)均下降(P<0.05);随访1 a后,研究组总体生存率[100.00%(64/64)]与对照组[96.88%(62/64)]相比,差异无统计学意义(P>0.05)。结论帕博利珠单抗联合IMRT治疗HER2阳性乳腺癌患者效果较好,可改善患者免疫功能。Objective To investigate the effect of pabolizumab combined with intensity modulated radiotherapy(IMRT)on immune function and prognosis of patients with human epidermal growth factor receptor 2(HER2)positive breast cancer.Methods This study utilised retrospective research methods to analyse the clinical data of 128 HER2-positive breast cancer patients from Zhengzhou Central Hospital Affiliated to Zhengzhou University,over the period from January 2021 to June 2023.The patients were segmented into two groups:a study group and a control group,with the allocation to these groups determined by postoperative treatment protocols.The study group received pabolizumab combined with IMRT radiotherapy,while the control group received pabolizumab monotherapy.The clinical efficacy[objective remission rate(ORR),disease control rate(DCR)]and immune function(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))were compared between the two groups.The patients were followed-up for one year and compare overall survival after one year of treatment in both groups.Results There was no significant difference in ORR between the two groups(P>0.05).DCR of study group was[79.69%(51/64)]higher than that of control group[62.50%(40/64)](P<0.05).There was no significant difference in CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)between the two groups before treatment(P>0.05).After 4 cycles of treatment,CD3^(+)and CD4^(+)in the study group were higher than those in the control group(P<0.05),and CD4^(+)/CD8^(+)were lower than those in the control group(P<0.05).Compared with before treatment,both CD3^(+)and CD4^(+)increased and CD4^(+)/CD8^(+)decreased(P<0.05).After a one year follow-up,the overall survival rate was 100.00%(64/64)in the study group and 96.88%(62/64)in the control group,and the difference was not statistically significant(P>0.05).Conclusion Pabolizumab combined with IMRT is effective in the treatment of HER2 positive breast cancer patients,which can improve their immune function and prolong their survival time.

关 键 词：乳腺癌 人表皮生长因子受体2 帕博利珠单抗 调强放疗 免疫功能 预后 

分 类 号：R737.9[医药卫生—肿瘤]