目的 比较免疫检查点抑制剂(immune checkpoint inhibitor,ICI)联合放化疗与同步放化疗治疗晚期食管癌的疗效及安全性.方法 回顾性分析 2019 年 1 月至 2023 年 1 月于安徽医科大学第二附属医院接受治疗的 67 例晚期食管癌患者的临床资料.根据治疗方案不同将纳入患者分为联合组(n=35)和放化疗组(n=32).比较两组患者的无进展生存(progress free survive,PFS)、客观缓解率(objective remission rate,ORR)、疾病控制率(disease control rate,DCR)和不良反应.结果 联合组患者的中位PFS显著长于放化疗组(12.6 个月 vs.6.3 个月,χ2=16.288,P<0.001);联合组患者的ORR显著高于放化疗组(54.3%vs.21.9%,P=0.011);联合组患者的DCR显著高于放化疗组(77.1%vs.53.1%,P=0.045).联合组患者的治疗相关不良反应及放化疗相关不良反应发生率均显著低于放化疗组(P<0.05);联合组出现免疫相关不良反应 11 例,均为 1～2 级不良反应.结论 ICI联合放化疗可提高晚期食管癌患者的疗效,不良反应可接受.
Objective To contrast the efficacy and safety of immune checkpoint inhibitor(ICI)combined with radiochemotherapy and concomitant radiochemotherapy in the treatment of advanced esophageal cancer.Methods The clinical data of 67 patients with advanced esophageal cancer who were treated in the Second Hospital of Anhui Medical University from January 2019 to January 2023 were retrospectively analyzed.Patients were divided into combination group(n=35)and radiochemotherapy group(n=32)according to different treatment plans.Progress free survival(PFS),objective remission rate(ORR),disease control rate(DCR)and adverse reactions were compared between two groups.Results The median PFS in combination group was significantly longer than that in radiochemotherapy group(12.6 months vs.6.3 months,χ2=16.288,P<0.001).ORR in combination group was significantly higher than that in radiochemotherapy group(54.3%vs.21.9%,P=0.011).DCR in combination group was significantly higher than that in radiochemotherapy group(77.1%vs.53.1%,P=0.045).The incidence of treatment-related adverse reactions and radiochemotherapy-related adverse reactions in combination group were significantly lower than those in radiochemotherapy group(P<0.05).There were 11 cases of immune-related adverse reactions in combination group,all of which were grade 1-2 adverse reactions.Conclusion ICI combined with radiochemotherapy can improve the curative effect of patients with advanced esophageal cancer,and the adverse reactions are acceptable.
李炳冰;张明军
安徽医科大学第二附属医院肿瘤内科,安徽合肥 230601
临床医学
食管癌;免疫检查点抑制剂;不良反应;疗效
Esophageal cancer;Immune checkpoint inhibitor;Adverse reaction;Therapeutic effect
《中国现代医生》 2024 (001)
39-42 / 4
安徽省自然科学基金项目(S201902b05020149)
10.3969/j.issn.1673-9701.2024.01.010
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