PD-1抑制剂与化疗联合125I粒子植入治疗晚期非小细胞肺癌的疗效及预后相关性分析OA

Objective To explore the efficacy and safety of programmed death-1(PD-1)inhibitors com-bined with chemotherapy and 125I particle implantation in advanced non-small cell lung cancer(NSCLC),and to further evaluate the influencing factors of disease progression.Methods A retrospective analysis was con-ducted on the clinical data of 61 NSCLC patients who received treatment at this hospital from September 2021 to December 2024.According to the different treatment methods,they were divided into the immunotherapy chemotherapy group(PD-1 inhibitor combined with chemotherapy,n=32)and the particle combination group(PD-1 inhibitor combined with chemotherapy and 125I particle implantation,n=29).The progression-free sur-vival(PFS)time,overall survival(OS)time,objective response rate(ORR),disease control rate(DCR),and adverse reaction occurrence were compared between the two groups.Results The median PFS time(16.00 months vs.9.04 months)and median OS time(18.70 months vs.13.89 months)in the particle combination group were significantly better than those in the immunotherapy chemotherapy group,the differences were statistically significant(P<0.05).The DCR in the particle combination group was significantly higher than that in the immunotherapy chemotherapy group(41.38%vs.12.50%),the difference was statistically signifi-cant(P<0.05).Multivariate Cox regression analysis showed that smoking,performance status(PS)score,125I particle combination treatment,neutrophil-to-lymphocyte ratio(NLR),and PLT-to-lymphocyte ra-tio(PLR)were the independent influencing factors for PFS time(P<0.05).In female,non-smokers,PS score 0-1,stage Ⅲ tumor,adenocarcinoma,no driver gene mutation,and first-line treatment,particle combi-nation therapy was a protective factor for disease progression(P<0.05).The interaction analysis results showed that particle combination therapy only had differences in smoking and treatment grade(interaction P<0.05).There was no statistically significant difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion PD-1 inhibitors combined with chemotherapy and 125I particle implanta-tion can significantly prolong the survival time of patients with advanced NSCLC.