信迪利单抗联合白蛋白结合型紫杉醇治疗晚期食管癌的临床观察

Clinical observation of Sintilimab combined with albumin-bound paclitaxel in the treatment of patients with advanced esophageal cancer

目的:探讨信迪利单抗联合白蛋白结合型紫杉醇治疗晚期食管癌的临床疗效.方法:选取2020年1月~2021年6月本院收治的84例晚期食管癌患者,依照随机数表分为观察组和对照组.对照组采用白蛋白结合型紫杉醇治疗,观察组在对照组的基础上另给予信迪利单抗治疗,21d为1个周期,用药至疾病进展或毒性不耐受.治疗3个周期后,比较两组患者功能状态(KPS)评分,生活质量(QOL)评分,客观缓解率(ORR),疾病控制率(DCR),血清细胞角蛋白19片段抗原(CYFRA21-1)和鳞状上皮细胞癌相关抗原(SCC)水平以及用药不良反应发生率,比较两组无进展生存期(PFS)、总生存期(OS).结果:治疗后两组患者KPS评分和QOL评分均升高,且观察组均高于对照组;观察组ORR和DCR均高于对照组;治疗后两组患者血清CYFRA21-1和SCC水平均降低,且观察组均低于对照组;两组患者不良反应发生率无统计学意义;观察组患者中位PFS和OS均高于对照组.结论:信迪利单抗联合白蛋白结合型紫杉醇用于治疗晚期食管癌患者能够缓解临床症状,疗效确切,能够降低肿瘤标志物水平,延长患者生存时间.

Objective To explore the clinical efficacy of Sintilimab combined with albumin-bound paclitaxel in the treat-ment of patients with advanced esophageal cancer.Methods Eighty-four patients with advanced esophageal cancer admitted to the hospital from January 2020 to June 2021 were selected and divided into observation group and control group according to the random number table.The control group was treated with nab-paclitaxel,and the observation group was treated with Sin-tilizumab on the basis of the control group,21d was a cycle,and medication to disease progression or toxicity intolerance.After 3 cycles of treatment,the functional status(KPS)score,quality of life(QOL)score,objective response rate(ORR),disease con-trol rate(DCR),serum cytokeratin 19 fragment antigen(CYFRA21-1)and squamous cell carcinoma-associated antigen(SCC)levels and the incidence of adverse drug reactions in the two groups of patients were compared,the progression-free survival(PFS)and overall survival(OS)of the two groups were compared.Results After treatment,the KPS score and QOL score of the two groups were increased(P<0.05),and the observation group were higher than the control group.The ORR and DCR of the observation group were higher than those of the control group.After treatment,the serum CYFRA21-1 and SCC levels of the two groups were decreased,and the observation group were lower than the control group.The incidence of adverse reactions in the two groups was not statistically significant.The median PFS and OS in the observation group were higher than those in the control group.Conclusion Sintilimab combined with albumin-bound paclitaxel for the treatment of patients with advanced es-ophageal cancer can relieve the clinical symptoms,have a definite effect,can reduce the level of tumor markers,and prolong the survival time of patients.