程序性死亡受体配体1抑制剂辅助化疗治疗非小细胞肺癌的临床疗效分析

Effect of programmed cell death 1 ligand 1 inhibitor adjuvant chemotherapy in the treatment of non-small cell lung cancer

目的探讨程序性死亡受体配体1(PD-L1)抑制剂辅助化疗治疗非小细胞肺癌(NSCLC)的临床效果。方法将96例术前辅助化疗的NSCLC患者按治疗方法不同分为观察组40例和对照组56例,观察组患者术前采用纳武利尤单抗实施辅助化疗,对照组患者采用多西他赛实施辅助化疗;对比两组患者化疗效果、化疗前后肿瘤相关标志物水平、术后2年的生存率及生存时间差异。结果观察组患者有效率高于对照组,差异有统计学意义(P﹤0.05)。化疗前,两组患者血清癌胚抗原(CEA)、糖类抗原125(CA125)、神经元特异性烯醇化酶(NSE)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)水平比较,差异均无统计学意义(P﹥0.05);化疗后,观察组患者血清CEA、NSE、CYFRA21-1水平均明显低于对照组,差异均有统计学意义(P﹤0.01)。化疗过程中,观察组患者恶心呕吐、腹泻、骨髓抑制发生率均低于对照组,差异均有统计学意义(P﹤0.05)。随访2年,两组患者生存率比较,差异无统计学意义(P﹥0.05);观察组患者生存时间长于对照组,差异有统计学意义(P﹤0.05)。结论PD-L1抑制剂辅助化疗治疗NSCLC患者较多西他赛具有更好的效果,对于延长患者的生存时间有一定价值。

Objective To investigate the clinical effect of programmed cell death 1 ligand 1(PD-L1)inhibitor adjuvant chemotherapy in the treatment of non-small cell lung cancer(NSCLC).Method A total of 96 NSCLC patients who received preoperative adjuvant chemotherapy were divided into observation group of 40 cases and control group of 56 cases according to different treatment methods.Patients in the observation group received adjuvant chemotherapy with nivolumab before surgery,while patients in the control group received adjuvant chemotherapy with docetaxel.The effect,tumor-related marker levels before and after chemotherapy,and the 2-year overall survival and survival time were compared between the two groups.Result The response rate of patients in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Before the chemotherapy,there were no significant differences in serum carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),neuron specific enolase(NSE),and cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)levels between the two groups(P>0.05).After the chemotherapy,the serum levels of CEA,NSE,and CYFRA21-1 in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.01).During the chemotherapy,the incidences of nausea,vomiting,diarrhea,and bone marrow suppression in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 2 years of follow-up,there was no significant difference in the overall survival between the two groups(P>0.05).The survival time of the observation group was longer than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Adjuvant chemotherapy with PD-L1 inhibitor in the treatment of NSCLC patients has a better effect compared to docetaxel,and has a certain value in prolonging the patients’survival.