PD-1PD-L1免疫治疗联合多西他赛化疗方案治疗晚期复治性NSCLC的疗效及安全性

Efficacy and safety of PD-1/PD-L1 immunotherapy combined with docetaxel chemotherapy in the treatment of advanced retreatable non-small cell lung cancer

目的探讨程序性细胞死亡受体-1(PD-1)及程序性细胞死亡配体-1(PD-L1)免疫治疗联合多西他赛化疗方案治疗晚期复治性非小细胞肺癌(NSCLC)的疗效及安全性。方法回顾性分析2017年07月~2019年07月本院收治的280例晚期复治性NSCLC患者的临床资料,根据治疗方法不同分为对照组(n=130)和观察组(n=150),对照组给予多西他赛化疗方案治疗,观察组给予PD-1/PD-L1免疫联合多西他赛化疗方案治疗,比较两组临床疗效、肿瘤标志物[细胞角蛋白19片段抗原21-1(CYFRA21-1)、癌胚抗原(CEA)]、免疫功能、不良反应发生率及1年总生存率和无进展生存期(PFS)。结果观察组RR高于对照组(P<0.05);治疗后观察组血清CYFRA21-1、CEA水平和CD8+低于对照组,CD3+、CD4+、CD4+/CD8+高于对照组(P<0.05);观察组PFS生存率和1年生存率高于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论PD-1/PD-L1免疫治疗联合多西他赛化疗方案治疗晚期复治性NSCLC疗效较好,可改善血清CYFRA21-1、CEA水平,提高免疫功能和生存率,且安全性较高。

Objective To analyze the efficacy and safety of programmed cell death 1(PD-1)and programmed cell death ligand-1(PD-L1)immunotherapy combined with docetaxel chemotherapy in the treatment of advanced retreatable non-small cell lung cancer(NSCLC).Methods The study retrospectively analyzed clinical data of 280 patients with advanced retreatableNSCLC treated between July 2017 and July 2019.Patients treated with docetaxel chemotherapy were included in the control group(n=130),while those treated with PD-1/PD-L1 immunotherapy combined with docetaxel chemotherapy were included in the observation group(n=150).Clinical effects,tumor markers[cytokeratin 19 fragment 21-1(CYFRA21-1),Carcinoembryonic antigen(CEA)],immune function,the incidences of adverse reactions and 1-year overall survival and progression-free survival(PFS).Results The RR of the observation group was higher than that of the control group(58.67%VS 38.46%)(P<0.05).After treatment,serum CYFRA21-1,CEA and CD8+levels in the observation group were lower than those in the control group,while CD3+,CD4+,and CD4+/CD8+were higher than those in the control group(P<0.05).The PFS survival rate and 1-year survival rate in observation group were higher than those in control group(P<0.05),and the incidence of adverse reactions was lower than that in the control group(20.00%VS 42.31%)(P<0.05).Conclusion PD-1/PD-L1 immunotherapy combined with docetaxel chemotherapy is effective in the treatment of advanced retreatable NSCLC,which can improve serum CYFRA21-1,CEA levels,immune function and survival rate,with high safety.