度伐利尤单抗联合EP方案治疗非小细胞肺癌的近远期疗效及对免疫功能的影响

Short-Term and Long-Term Efficacy of Durvalumab Combined with EP Regimen in the Treatment of Non-Small Cell Lung Cancer and Its Effect on the Immune Function

目的探讨度伐利尤单抗联合依托泊苷+顺铂(EP)方案治疗非小细胞肺癌(NSCLC)的近远期疗效,以及对患者免疫功能的影响。方法选取博鳌未来医院2018年1月至2020年1月收治的NSCLC患者102例,按随机数字表法分为观察组和对照组,各51例。对照组患者实施EP方案,观察组患者加用度伐利尤单抗,均连续治疗3个化疗周期。结果观察组患者的客观缓解率和疾病控制率分别为62.75%和76.47%,均显著高于对照组的43.14%和56.86%(P<0.05)。治疗后,观察组患者的血清肿瘤标志物(癌胚抗原、鳞状细胞癌相关抗原、糖链抗原50)水平均显著低于对照组(P<0.05);观察组患者的T淋巴细胞亚群CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)均显著高于对照组,CD_(8)^(+)水平显著低于对照组(P<0.05)。观察组患者的无病生存期、无进展生存期、总生存期均显著长于对照组(P<0.05)。观察组和对照组治疗期间药品不良反应发生率相当(17.65%比11.76%,P>0.05)。结论度伐利尤单抗联合EP方案治疗NSCLC的近远期疗效显著,能改善患者的肿瘤标志物水平,提升免疫功能,延长生存周期,且安全性较好。

Objective To investigate the short-term and long-term efficacy of durvalumab combined with etoposide+cisplatin(EP)regimen in the treatment of non-small cell lung cancer(NSCLC),and its effect on the immune function of patients.Methods A total of 102 patients with NSCLC admitted to the Boao Future Hospital from January 2018 to January 2020 were selected and divided into the observation group and the control group according to the random number table method,with 51 cases in each group.Patients in the control group were treated with EP regimen,on this basis,patients in the observation group were treated with durvalumab.Both groups were treated continuously for three chemotherapy cycles.Results The objective response rate(ORR)and disease control rate(DCR)in the observation group were 62.75%and 76.47%respectively,which were significantly higher than 43.14%and 56.86%in the control group(P<0.05).After treatment,the levels of serum tumor markers such as carcinoembryonic antigen(CEA),squamous cell carcinoma associated antigen(SCC)and carbohydrate antigen 50(CA50)in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the T lymphocyte subsets such as CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)in the observation group were significantly higher than those in the control group,while the level of CD_(8)^(+)was significantly lower than that in the control group(P<0.05).The disease-free survival(DFS),progression-free survival(PFS)and overall survival(OS)in the observation group were significantly longer than those in the control group(P<0.05).During the treatment,the incidence of adverse drug reactions in the observation group was similar to that in the control group(17.65%vs.11.76%,P>0.05).Conclusion Durvalumab combined with EP regimen has significant short-term and long-term efficacy in the treatment of NSCLC,which can improve the level of tumor markers and immune function,prolong the survival cycle of patients,and it has good safety.