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目的 探究卡瑞利珠单抗联合同步放化疗对食管癌患者的治疗效果及安全性。方法 回顾性分析2020年9月至2023年9月于运城市中心医院就诊的156例食管癌患者的临床资料。根据不同治疗方式将患者分为联合组(卡瑞利珠单抗联合同步放化疗，78例)和对照组(同步放化疗，78例)。比较两组临床疗效、程序性死亡受体1(PD-1)和细胞程序性死亡-配体1(PD-L1)水平、生活质量及不良反应发生情况。结果 治疗后，联合组患者的客观缓解率和疾病控制率分别为79.49%(62/78)和96.15%(75/78)，高于对照组的60.26%(47/78)和82.05%(64/78)(χ2=6.851,7.988，均P<0.05)。治疗后，联合组患者的PD-1、PD-L1水平[分别为(201.81±16.12) ng·L-1、(264.32±25.10) ng·L-1]均低于对照组[分别为(232.23±19.58) ng·L-1、(301.28±27.42) ng·L-1](t=10.593、8.781，均P<0.05)；联合组患者的生活质量改善率为85.90%(67/78)，高于对照组患者的71.79%(56/78)(χ2=4.650,P<0.05)。在不良反应方面，两组患者的消化道反应、白细胞减少、放射性食管炎、贫血及血小板减少发生率较高，但多为1～2级不良反应，大部分患者可耐受，经对症处理后未影响治疗进程。两组不良反应发生率比较差异均无统计学意义(均P>0.05)。结论 卡瑞利珠单抗联合同步放化疗对食管癌患者具有良好的治疗效果，能降低血清PD-1、PD-L1水平，改善患者生活质量，相较于常规同步放化疗并未增加不良反应发生风险。
Abstract：Objective To investigate the therapeutic effect and safety of camrelizumab combined with simultaneous radiotherapy and chemotherapy for esophageal cancer.Methods The clinical data of 156 patients with esophageal cancer treated in Yuncheng Central Hospital from September 2020 to September 2023 were retrospectively analyzed.The patients were divided into the combination group (karelizumab combined with simultaneous radiotherapy and chemotherapy,n=78) and the control group (simultaneous radiotherapy and chemotherapy,n=78) according to the treatment modality.The therapeutic effect,programmed death 1 (PD-1) and programmed cell death 1 ligand 1 (PD-L1) levels,quality of life evaluation and the toxicological reaction were compared between the two groups.Results After treatment,the objective remission and disease control rates in the combination group were 79.49%(62/78) and 96.15%(75/78),respectively,which were higher than those of 60.26%(47/78) and 82.05%(64/78) in the control (χ2=6.851,7.988,both P<0.05).The PD-1 and PD-L1 levels in the combination group ((201.81±16.12) ng·L-1 and (264.32±25.10) ng·L-1) were lower than those in the control group ((232.23±19.58) ng·L-1 and (301.28±27.42) ng·L-1)(t=10.593,8.781,both P<0.05).The rate of improvement in the quality of life in the combined group was 85.90%(67/78),which was higher than that of 71.79%(56/78) in the control,(χ2=4.650,P<0.05).In terms of adverse reactions,the incidence of gastrointestinal reactions,leukopenia,radiation esophagitis,anaemia and thrombocytopenia was increased in both groups,but they were mostly grade 1-2 adverse reactions,which could be tolerated by most of the patients.Meanwhile,it did not affect the course of treatment after symptomatic treatment.There was no significant difference in the probability of toxic side effects between the two groups(all P>0.05).Conclusion Camrelizumab combined with simultaneous radiotherapy and chemotherapy has favourable therapeutic results in patients with esophageal cancer since it can reduce serum PD-1 and PD-L1 levels,improve the quality of life of patients and does not increase the risk of adverse reactions as compared with conventional simultaneous radiotherapy.
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基本信息:
中图分类号:R735.1;R969
引用信息:
[1]王海峰,王伟,梁朝晖,等.卡瑞利珠单抗联合同步放化疗对食管癌患者的疗效及安全性[J].中国药物应用与监测,2024,21(05):596-600.
2024-10-25
2024-10-25