沙利度胺联合免疫治疗及化疗对晚期食管癌患者的临床疗效观察  

Clinical observation of thalidomide combined with immunotherapy and chemotherapy in patients with advanced esophageal cancer

作　　者：周冬霞 徐寿华 周立莉 蔡茂怀 ZHOU Dong-xia;XU Shou-hua;ZHOU Li-li(Yancheng Second People's Hospital,Yancheng 224000,China)

机构地区：[1]盐城市第二人民医院,224000

出　　处：《中国实用医药》2025年第6期16-19,共4页China Practical Medicine

摘　　要：目的 观察沙利度胺联合免疫治疗及化疗对晚期食管癌患者的临床疗效。方法 选取32例晚期食管癌患者为研究对象,随机分为联合治疗组和对照组,每组16例。联合治疗组接受沙利度胺、免疫治疗和化疗的联合治疗方案,对照组仅接受化疗。对比两组治疗前后的免疫细胞(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平,临床疗效,临床不良反应发生情况。结果 联合治疗组患者治疗后的CD4^(+)(37.19±4.95)%、CD4^(+)/CD8^(+)(1.65±0.22)高于对照组的(32.92±3.87)%、(1.24±0.13)CD8^(+)(22.48±2.91)%低于对照组的(26.57±3.12)%,差异均有统计学意义(P<0.05)。联合治疗组患者的治疗效果明显优于对照组,差异有统计学意义(Z=2.498,P=0.013<0.05)。联合治疗组患者的丙氨酸氨基转移酶(ALT)或谷草转氨酶(AST)升高≥3级发生率37.50%、反应性皮肤毛细血管增生症发生率25.00%高于对照组的6.25%、0,差异有统计学意义(P<0.05)。结论 沙利度胺联合免疫治疗及化疗可以有效改善晚期食管癌患者的免疫状态,提高临床疗效,并具有较好的安全性,这种联合治疗方案可能成为晚期食管癌治疗的一种新策略,值得进一步研究和推广应用。Objective To observe the clinical efficacy of thalidomide combined with immunotherapy and chemotherapy on patients with advanced esophageal cancer.Methods 32 patients with advanced esophageal cancer were selected as study subjects and randomly divided into combined treatment group and control group,with 16 cases in each group.The combined treatment group received a combination of thalidomide,immunotherapy and chemotherapy,while the control group received chemotherapy alone.The levels of immune cells (CD4^(+),CD8^(+),CD4^(+)/CD8^(+)) before and after treatment,clinical efficacy and occurrence of clinical adverse reactions were compared between the two groups.Results After treatment,the combined treatment group had CD4^(+)of(37.19±4.95)% and CD4^(+)/CD8^(+) of (1.65±0.22),which were higher than (32.92±3.87)% and (1.24±0.13) in the control group;the combined treatment group had a lower CD8^(+) of (22.48±2.91)% than (26.57±3.12)% in the control group;the differences were statistically significant (P<0.05).The therapeutic effect of the combined treatment group was significantly better than that of the control group,and the difference was statistically significant (Z=2.498,P=0.013<0.05).The incidence of alanine aminotrasferase (ALT) or aspartate transaminase(AST) elevation≥3 grades was 37.50% and the incidence of reactive cutaneous capillary hyperplasia was 25.00% in the combined treatment group,which were higher than 6.25% and 0 in the control group,and the difference was statistically significant (P<0.05).Conclusion Thalidomide combined with immunotherapy and chemotherapy can effectively improve the immune status of patients with advanced esophageal cancer,enhance clinical efficacy,and have good safety.This combination therapy may become a new strategy for the treatment of advanced esophageal cancer,and is worthy of further study and promotion.

关 键 词：沙利度胺 免疫治疗 化疗 晚期食管癌 免疫功能 临床疗效 

分 类 号：R735.1[医药卫生—肿瘤]