帕博利珠单抗联合新辅助化疗治疗Ⅱ、Ⅲ期食管癌临床疗效

Clinical efficacy of pembrolizumab combined with neoadjuvant chemotherapy in treatment of stage Ⅱ and Ⅲ esophageal cancer

目的:探究帕博利珠单抗与新辅助化疗联合用于Ⅱ、Ⅲ期食管癌治疗的临床疗效。方法:采用随机数字表法将92例食管癌患者分为两组。对照组选用白蛋白结合型紫衫醇联合奈达铂进行新辅助化疗;观察组在对照组新辅助化疗基础上使用帕博利珠单抗进行免疫治疗。对比两组化疗期间药物使用情况、临床效果、不良反应发生情况及随访总生存期(OS)。结果:与对照组比,观察组化疗周期、粒细胞集落刺激因子(GSF)使用人数和化疗药物剂量减少次数均明显减少(均P<0.05);完全缓解(CR)、客观缓解率(ORR)和疾病控制率(DCR)明显增大(均P<0.05)。两组主要不良反应发生情况间比较差异无统计学意义(P>0.05)。观察组OS中位生存时间明显长于对照组(P<0.05)。结论:Ⅱ、Ⅲ期食管癌新辅助化疗过程中联合使用帕博利珠单抗,能有效缩短化疗周期,减少骨髓抑制,增强临床治疗效果,延长生存时间。

Objective:To investigate the clinical effect of pembrolizumab combined with neoadjuvant chemotherapy in the treatment of stageⅡandⅢesophageal cancer.Methods:A total of 92 patients with esophageal cancer were divided into two groups by random number table method.The control group albumin-bound paclitaxel combined with nedaplatin for neoadjuvant chemotherapy,while the observation group was treated with pembrolizumab based on neoadjuvant chemotherapy in the control group for immunotherapy.The drug usage,clinical effects,adverse reactions and follow-up overall survival(OS)during chemotherapy were compared between the two groups.Results:Compared with the control group,the chemotherapy cycles,the number of granulocyte colony-stimulating factor(GSF)users and the number of dose reductions of chemotherapy drugs in the observation group were significantly reduced(all P<0.05);complete remission(CR),objective response rate(ORR)and disease control rate(DCR)were significantly increased(all P<0.05).There was no significant difference in the occurrence of major adverse reactions between the two groups(all P>0.05).The median survival time of OS in the observation group was significantly longer than that in the control group(P<0.05).Conclusion:Combined use of pembrolizumab during neoadjuvant chemotherapy for stage Ⅱ and Ⅲ esophageal cancer can effectively shorten the chemotherapy cycle,reduce myelosuppression,enhance clinical treatment effect,prolong survival time,and is safe and reliable.