信迪利单抗联合化疗转化治疗不可切除局部晚期食管鳞癌的疗效与预后分析OA

Objective To explore the effect of conversion therapy with sintilimab combined with the TP chemotherapy regimen in locally advanced unresectable esophageal squamous cell carcinoma(ESCC)and its influence on prognosis.Methods A total of 82 patients with locally advanced unresectable ESCC who were admitted to Zhangjiagang Hospital Affiliated to Suzhou University between July 2022 and August 2024 were retrospectively analyzed.Based on different treatment regimens,they were categorized into the control group(receiving the TP regimen,29 cases)and the combination group(receiving sintilimab in combination with the TP regimen,53 cases).After 4 cycles of basic treatment(3 weeks per cycle),the combination group was administered sintilimab monotherapy until disease progression or intolerable toxicity occurred.The success rate of conversion therapy,objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS),overall survival(OS),levels of serum tumor markers[carcinoembryonic antigen(CEA),cytokeratin 19 fragment 21-1(CY-FRA21-1),squamous cell carcinoma antigen(SCC-Ag),programmed death-1(PD-1),and programmed death-ligand 1(PD-L1)]before and after treatment,incidence of adverse reactions,and major pathological response(MPR)were compared between the two groups.Results The success rate of conversion therapy in the combina-tion group was significantly higher than that in the control group(35.85％ vs.13.79％,P＜0.05).The ORR and DCR in the combination group were 60.38％ and 88.68％ respectively,which were significantly higher than those in the control group(34.48％and 68.97％respectively,P＜0.05).The median PFS in the combination group was significantly longer than that in the control group(9.6 months vs.6.2 months,Log-rankx2=9.872,P=0.002),and the median OS was also significantly longer than that in the control group(17.8 months vs.12.1 months,Log-rank x2=12.543,P＜0.001).After treatment,the levels of serum CEA,CYFRA21-1,and SCC-Ag,the propor-tions of cases with abnormal conditions and PD-L1 in the combination group were significantly lower than those in the control group(P＜0.05).The incidence of MPR in the combination group was significantly higher than that in the control group(63.16％ vs.25.00％,P＜0.05).Conclusion Sintilimab combined with paclitaxel liposome and cisplatin can significantly increase the success rate of conversion therapy,improve the short-term curative effect and long-term survival of patients with locally advanced unresectable ESCC,and it has good safety.