替雷利珠单抗联合多西他赛二/三线治疗晚期非小细胞肺癌的临床观察  

Clinical Observation of Tirellizumab Combined with DocetaxelⅡ/Ⅲin Treatment of Advanced Non-Small Cell Lung Cancer

作　　者：李婉萍[1] 甄振华[1] 王亚[1] 赵芳 刘威 胡志国 Li Wanping;Zhen Zhenhua;Wang Ya(Department of Oncology,Huaibei People's Hospital,Huaibei,Anhui 235000,China)

机构地区：[1]淮北市人民医院肿瘤内科,安徽淮北235000

出　　处：《四川医学》2025年第4期412-417,共6页Sichuan Medical Journal

基　　金：淮北市科技计划项目(编号:r201818)。

摘　　要：目的探究替雷利珠单抗联合多西他赛二/三线治疗晚期非小细胞肺癌(NSCLC)的临床疗效。方法选取2021年1月至2022年12月我院收治的96例NSCLC患者,采用随机数字表法将其分为A组、B组及联合组,各32例。A组采用多西他赛单药化疗,B组采用替雷利珠单抗治疗,联合组采用替雷利珠单抗联合多西他赛进行治疗。治疗2个周期后评估患者的临床疗效并检测患者血清肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白21-1片段(CYFRA21-1)],观察患者药物不良反应情况并分析患者生存情况(生存率及无进展生存率)。结果经卡方检验,3组疾病进展(PD)率及疾病控制率(DCR)比较,差异有统计学意义(P<0.05);与A组、B组比较,联合组PD率降低,DCR升高(P<0.05)。重复测量方差分析结果显示,3组NSCLC患者CEA及CYFRA21-1水平时间和组间存在交互作用,差异有统计学意义(P<0.05),3组患者治疗后的CEA、CYFRA21-1水平均下降(P<0.05);与A组比较,B组、联合组治疗后CEA、CYFRA21-1水平均降低(P<0.05),与B组比较,联合组治疗后CEA、CYFRA21-1水平降低(P<0.05)。3组患者胃肠道反应(恶心呕吐)、脱发、过敏反应、甲状腺功能减退、呼吸道症状、白细胞减少、中性粒细胞减少、血小板减少、肝功能异常、肾功能异常及骨髓抑制等Ⅰ~Ⅱ级药物不良反应发生率比较,差异均无统计学意义(P>0.05);所有患者均随访1年,无失访,96例患者死亡56例;A组、B组及联合组生存率分别为31.25%、34.38%及59.38%;无进展生存率分别为21.88%、25.00%及46.88%;经Log-Rank检验,3组NSCLC晚期患者1年内生存曲线差异有统计学意义(Log-Rank X^(2)=9.266,P=0.010),3组NSCLC患者1年内无进展生存曲线差异有统计学意义(Log-Rank X^(2)=10.023,P=0.007)。结论替雷利珠单抗联合多西他赛二/三线治疗能够提高晚期NSCLC患者DCR,降低PD,改善血清肿瘤标志物水平,有效延长患者生存时间。该治疗方案药物不良反应未见明�Objective To explore the clinical efficacy of tirellizumab combined with docetaxelⅡ/Ⅲin the treatment of advanced non-small cell lung cancer(NSCLC).Methods A total of 96 patients with NSCLC admitted to our hospital from January 2021 to December 2022 were selected.They were divided into 3 groups(group A,group B and combined group)by random number table method,with 32 cases in each group.Group A was treated with docetaxel monotherapy,group B was treated with tirellizumab,and the combined group was treated with tirellizumab combined with docetaxel.After 2 cycles of treatment,clinical efficacy was evaluated and serum tumor markers[(carcinoembryonic antigen(CEA),cytokeratin 21-1 fragment(CYFRA21-1)]were detected.Adverse drug reactions were observed and the survival(survival rate and progression-free survival rate)was analyzed.Results Chi-square test showed that there were significant differences in disease progression(PD)rate and disease control rate(DCR)among the three groups(P<0.05).Compared with groups A and B,the PD rate of the combined group was decreased while the DCR was increased(P<0.05).Repeated measurement ANOVA results showed that CEA and CYFRA21-1 levels of NSCLC patients in the 3 groups had interactions with each other,and the difference was statistically significant(P<0.05).The levels of CEA and CYFRA21-1 in the three groups were all decreased after treatment(P<0.05).Compared with group A,the levels of CEA and CYFRA21-1 in group B and the combined group were decreased after treatment(P<0.05);Compared with group B,the levels of CEA and CYFRA21-1 in the combined group were decreased after treatment(P<0.05).The interaction between time and groups was statistically significant(P<0.05).There was no significant difference in the incidence of grade I to II adverse drug reactions in gastrointestinal reactions(nausea and vomiting),alopecia,anaphylaxis,hypothyroidism,respiratory symptoms,leukopenia,neutropenia,thrombocytopenia,abnormal liver function,abnormal kidney function and bone marrow suppression among 3

关 键 词：非小细胞肺癌 晚期 替雷利珠单抗 多西他赛 疗效 

分 类 号：R734.2[医药卫生—肿瘤]