替雷利珠单抗联合替吉奥二线治疗复发转移性食管鳞状细胞癌的效果及安全性  

Efficacy and safety of trellizumab combined with tegafur in second-line treatment of relapsed and metastatic esophageal squamous cell carcinoma

作　　者：钟莉萍 吴斌[1] Zhong Liping;Wu Bin(Department of Pharmacy,Nanjing Tongren Hospital Affiliated to School of Medicine,Southeast University,Nanjing 211100,China)

机构地区：[1]东南大学医学院附属南京同仁医院药学部,南京211100

出　　处：《中国医师杂志》2025年第3期417-421,427,共6页Journal of Chinese Physician

摘　　要：目的研究替雷利珠单抗联合替吉奥二线治疗复发转移性食管鳞状细胞癌(ESCC)的临床疗效及安全性。方法前瞻性选取2020年1月—2023年1月于南京同仁医院就诊的复发转移性ESCC患者80例,按随机数字表法分为替吉奥组、联合组,各40例。替吉奥组采用奥沙利铂联合替吉奥二线治疗方案,联合组在替吉奥组基础上联合替雷利珠单抗治疗。比较替吉奥组、联合组近期疗效、不良反应及生存时间;比较替吉奥组、联合组治疗前、后鳞状细胞癌抗原(SCC)、淋巴细胞/单核细胞比值(LMR)、血小板/淋巴细胞比值(PLR)、细胞免疫功能及生活质量。结果替吉奥组、联合组的总有效率分别为32.50%(13/40)、55.00%(22/40),中位生存时间分别为10、14个月,联合组的上述指标均优于替吉奥组(均P<0.05)。替吉奥组、联合组白细胞减少、中性粒细胞减少、脱发、骨髓抑制、出血及胃肠道反应发生率比较,差异均无统计学意义(均P>0.05)。治疗后,替吉奥组、联合组的SCC水平分别为(3.10±0.58)ng/ml和(2.24±0.63)ng/ml,PLR分别为136.65±17.40、122.24±18.33,LMR分别为4.28±0.78、5.33±0.85,CD4^(+)T淋巴细胞百分率分别为(36.36±4.11)%和(41.18±4.05)%,CD8^(+)T淋巴细胞百分率分别为(33.14±3.87)%和(28.46±3.77)%,CD4^(+)/CD8^(+)比值分别为1.10±0.14、1.45±0.19,生活质量核心量表(QLQ-C30)评分分别为(63.25±7.01)分和(67.14±6.84)分,食管癌患者补充量表(QLQ-OES18)评分分别为(50.24±6.98)分和(45.30±7.11)分,差异均有统计学意义(均P<0.05)。结论复发转移性ESCC采用替雷利珠单抗联合替吉奥二线治疗可改善患者近期疗效及SCC、LMR、PLR,增强细胞免疫能力,提高生存质量,延长生存期,且安全性高。ObjectiveTo study the clinical efficacy and safety of trellizumab combined with tegafur in the treatment of relapsed and metastatic esophageal squamous cell carcinoma(ESCC).MethodsA total of 80 patients with relapsed and metastatic ESCC who were admitted to the Nanjing Tongren Hospital from January 2020 to January 2023 were prospectively selected and divided into tegafur group and combination group with 40 patients each according to random number table method.The tegafur group was treated with oxaliplatin combined with tegafur second-line therapy,and the combined group was treated with trellizumab based on the tegafur group.The short-term efficacy,adverse reactions and survival time of the tegafur group and the combination group were compared.Squamous cell carcinoma(SCC),lymphocyte-to-monocyte ratio(LMR),platelet-to-lymphocyte ratio(PLR),cellular immune function and quality of life were compared between the tegafur group and the combination group.ResultsThe total effective rate of the combined group was 32.50%(13/40)and 55.00%(22/40),and the median survival time was 10 and 14 months,respectively.The above indexes in the combined group were better than those in the tegafur group(all P<0.05).There were no significant differences in the incidence of leukopenia,neutropenia,alopecia,bone marrow suppression,bleeding and gastrointestinal reactions between the two groups(all P>0.05).After treatment,SCC levels in the Tegafur group and the combination group were(3.10±0.58)ng/ml and(2.24±0.63)ng/ml,PLR were 136.65±17.40 and 122.24±18.33,LMR were 4.28±0.78 and 5.33±0.85,respectively.The percentages of CD4^(+)T lymphocytes were(36.36±4.11)%and(41.18±4.05)%,the percentages of CD8^(+)T lymphocytes were(33.14±3.87)%and(28.46±3.77)%,and the CD4^(+)/CD8^(+)ratios were 1.10±0.14 and 1.45±0.19,respectively.The scores of the Quality of Life Questionnaire-Core 30(QLQ-C30)were(63.25±7.01)and(67.14±6.84),and the scores of the Quality of Life Questionnaire-Oesophagus 18(QLQ-OES18)were(50.24±6.98)and(45.30±7.11),respective

关 键 词：抗肿瘤联合化疗方案 食管鳞状细胞癌 替雷利珠单抗 替吉奥 

分 类 号：R735.1[医药卫生—肿瘤]