20例晚期肿瘤患者免疫检查点抑制剂不良反应临床观察并文献复习

Clinical Observation of Adverse Events of Immune Checkpoint Inhibitors in 20 Advanced Tumor Patients and Literature Reviews

目的观察免疫检查点抑制剂治疗的相关不良反应。方法回顾性分析2017年3月—2019年8月在中国医学科学院肿瘤医院进行免疫检查点抑制剂治疗的20例晚期肿瘤患者临床资料,总结免疫检查点抑制剂治疗的相关不良反应。结果20例患者免疫治疗中位时间为4.0月,发生较明确免疫治疗相关不良反应的共6例,中位时间5.3月,其中1例发生Ⅰ级免疫性胃肠炎,1例Ⅰ级免疫性皮炎,1例Ⅱ级免疫性甲状腺炎,1例Ⅲ级免疫性肝炎,1例Ⅲ级免疫性肺炎及1例Ⅳ级免疫性肺炎。结论伴随免疫治疗的相关不良反应发生率较高,严重的不良反应甚至危及生命,故免疫相关不良反应的早发现、早诊断及早干预至关重要。

Objective To observe the toxicities of immune checkpoint inhibitors.Methods We retrospectively analyzed the clinical data of 20 advanced tumor patients who received immune checkpoint inhibitors therapy in Cancer Hospital of Chinese Academy of Medical Sciences from March 2017 to August 2019,and collected the immune-related adverse events.Results The median immunotherapy time was 4.0 months.The immune-related adverse events occurred in 6 patients:one case of gradeⅠgastroenteritis,one case of gradeⅠdermatitis,one case of gradeⅠthyroiditis,one case of gradeⅢhepatitis,one case of gradeⅢpneumonia and one case of gradeⅣpneumonia;the median time of occurrence was 5.3 months.Conclusion As the incidence of immune-related adverse events is relatively high and sometimes lifethreatening,it is crucial for early recognition,accurate diagnosis and prompt intervention of the toxicities associated with immune checkpoint inhibitors.