摘要
目的观察帕博利珠单抗联合化疗治疗晚期非小细胞肺癌(NSCLC)的疗效及对肿瘤标志物及胃肠道反应的影响。方法选取2019年6月至2021年10月安徽医科大学安庆医学中心/安庆市立医院收治的晚期NSCLC患者82例。告知患者两种方案后,遵患者意愿分为化疗组和联合组各41例。化疗组采用培美曲塞联合顺铂治疗,联合组在化疗组基础上联合帕博利珠单抗治疗。比较两组临床疗效、胃肠道反应,治疗前、后肿瘤标志物水平变化,及两组生存情况。结果联合组临床总有效率高于化疗组(P<0.05)。治疗前,化疗组、联合组血清癌胚抗原(CEA)、鳞状细胞癌相关抗原(SCC-Ag)、细胞角蛋白19血清片段21-1(CYFRA21-1)水平比较,差异无统计学意义(P>0.05);治疗后组内比较,化疗组、联合组血清CEA、SCC-Ag、CYFRA21-1水平均降低,组间比较,联合组血清CEA、SCC-Ag、CYFRA21-1水平低于化疗组(P<0.05)。化疗组、联合组胃肠道反应发生率比较,差异无统计学意义(P>0.05)。随访至2022年10月,化疗组的中位生存时间为8个月(95%CI:6.416~9.584),联合组的中位生存时间为12个月。Log-rank检验显示,Kaplan-Meier曲线差异有统计学意义(χ^(2)=20.606,P<0.001)。结论帕博利珠单抗联合化疗可改善晚期NSCLC近期疗效,降低肿瘤标志物水平,延长生存期,且不会明显增加胃肠道反应。
Objective To observe the efficacy of Pabolizumab combined with chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC)and its effect on tumor markers and gastrointestinal response.Methods A total of 82 patients with advanced NSCLC admitted to Anqing Medical Center of Anhui Medical University/Anqing Municipal Hospital from June 2019 to October 2021 were divided into chemotherapy group and combination group,with 41 cases in each group.The patients in chemotherapy group were treated with Pemetrexed combined with cisplatin.And the patients in combination group were treated with Pabolizumab on the basis of the treatment in chemotherapy group.The short-term clinical efficacy and gastrointestinal reaction were compared between the two groups.The levels of tumor markers before and after treatment were compared as well.Follow-up results were compared between the two groups until October 2022.Results The total effective rate of the combined group was higher than that of chemotherapy group(P<0.05).Before the treatment,there was no significant difference on the levels of serum carcinoembryonic antigen(CEA),squamous cell carcinoma associated antigen(SCC-Ag)and cytokeratin 19 serum fragment 21-1(CYFRA21-1)between the chemotherapy group and the combined group(P>0.05),which decreased after the treatment.And the levels of serum CEA,SCC-Ag and CYFRA21-1 in the combination group were lower than those in the chemotherapy group(P<0.05).There was no significant difference on the incidence of gastrointestinal reactions between the two groups(P>0.05).The median survival time was 8 months(95%CI:6.416-9.584)in the chemotherapy group and 12 months in the combined grou.Log-rank test showed that the difference between Kaplan-Meier curves was statistically significant(χ2=20.606,P<0.001).Conclusions Pabolizumab combined with chemotherapy improves the short-term efficacy of advanced NSCLC,reduces the level of tumor markers,prolongs the survival time,which doesn't increase gastrointestinal reactions significantly.
作者
江恕
李承慧
谢黎黎
王爱娟
JIANG Shu;LI Chenghui;XIE Lili;WANG Aijuan(Department of Oncology,Anqing Medical Center of Anhui Medical University/Anqing Municipal Hospital,Anqing 246000,China)
出处
《中国肿瘤外科杂志》
CAS
2023年第2期158-161,共4页
Chinese Journal of Surgical Oncology
