帕博利珠单抗联合培美曲塞+顺铂化疗方案在晚期肺腺癌中的应用效果

Application effect of Pembrolizumab combined with Pemetrexed and Cisplatin chemotherapy on advanced lung adenocarcinoma

目的观察帕博利珠单抗联合培美曲塞+顺铂(AP)化疗治疗晚期肺腺癌的临床效果及安全性。方法回顾性选取2018年6月至2020年6月南京医科大学附属苏州医院肿瘤内科收治的78例局部晚期及晚期肺腺癌患者作为研究对象,根据患者的治疗方案将患者分为AP化疗组(n=37)和联合组(n=41)。AP化疗组采用AP方案(培美曲塞500 mg/m2+顺铂75 mg/m2)化疗,联合组在AP方案基础上联合帕博利珠单抗(200 mg固定剂量)。比较两组患者的治疗效果、生活质量评分(QOL)、无进展生存期(PFS)、1年内无进展生存率以及治疗期间的不良反应。结果联合组的疾病缓解率和疾病控制率高于AP化疗组,差异有统计学意义(P<0.05);联合组患者的生活质量好转率高于AP化疗组,差异有统计学意义(P<0.05);联合组患者的1年无进展生存率高于AP化疗组,PFS长于AP化疗组,差异有统计学意义(P<0.05);两组患者的药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论帕博利珠单抗联合AP方案化疗能够取得更为理想的短期效果,同时还能在一定程度上延长患者的生存时间,且不良反应能够被接受,为临床晚期肺腺癌患者的治疗提供了新的方向。

Objective To observe the clinical effect and safety of Pembrolizumab combined with Pemetrexed and Cisplatin(AP)chemotherapy in the treatment of advanced lung adenocarcinoma.Methods A total of 78 patients with locally advanced and advanced lung adenocarcinoma admitted to Department of Medical Oncology of Suzhou Hospital Affiliated to Nanjing Medical University from June 2018 to June 2020 were enrolled as the research objects retrospectively.According to different treatment methods,they were divided into AP chemotherapy group(n=37)and combination group(n=41).AP chemotherapy group was treated with AP chemotherapy(Pemetrexed 500 mg/m2+Cisplatin 75 mg/m2),while combination group was treated with Pembrolizumab(200 mg)on basis of AP regimen.The curative effect,score of quality of life(QOL),progression-free survival(PFS),progression-free survival rate within 1 year and adverse reactions during treatment were compared between the two groups.Results The disease remission rate and disease control rate in combination group were higher than those in AP chemotherapy group,the differences were statistically significant(P<0.05).Improvement rate of quality of life in the combination group was higher than that in AP chemotherapy group,the difference was statistically significant(P<0.05).The progression-free survival rate within 1 year in combination group was higher than that in AP chemotherapy group,and PFS was longer than that in AP chemotherapy group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion The short-term curative effect of Pembrolizumab combined with AP chemotherapy is more ideal,which can prolong survival time of patients to a certain extent,with few adverse reactions.And it provides new direction for clinical treatment of patients with advanced lung adenocarcinoma.