程序性死亡受体-1单抗在晚期食管鳞癌综合治疗中的临床分析

Clinical analysis of PD-1 inhibitors in comprehensive treatment of patients with advanced esophageal squamous cell carcinoma

目的 探讨晚期食管鳞癌(ESCC)患者二线及二线以上使用以程序性细胞死亡蛋白-1(PD-1)单抗为主的综合治疗的疗效及安全性。方法 回顾性分析2017年6月至2020年12月在郑州大学附属肿瘤医院收治的73例食管鳞癌患者的临床资料,对其基本资料、疗效、无进展生存期(PFS)和不良反应进行分析。结果 73例二线及二线以上接受PD-1单抗治疗的ESCC患者中,完全缓解1例(1.36%),部分缓解21例(28.77%),疾病稳定45例(61.64%),疾病进展6例(8.22%)。总体客观缓解率为30.14%(22/73),总体疾病控制率为91.78%(67/73)。中位PFS为7.43个月(95%CI:4.78~10.09)。1~2级免疫相关不良反应发生率为52.1%(38/73),3~4级免疫相关不良反应发生率为11.0%(8/73)。结论 真实世界中晚期食管鳞癌患者使用PD-1单抗综合治疗具有良好的疗效,且总体不良反应可控。

Objective To investigate the efficacy and safety of second-line and above treatment with programmed cell death protein-1(PD-1)monoclonal antibody in patients with advanced esophageal squamous cell carcinoma(ESCC).Methods The clinical data of 73 patients with esophageal squamous cell carcinoma treated in the Affiliated Cancer Hospital of Zhengzhou University from June 2017 to December 2020 were retrospectively analyzed.The basic data,efficacy,progression free survival(PFS)and adverse reactions were analyzed.Results Among 73 patients with ESCC who received second-line or above treatment with PD-1 monoclonal antibody,1 case(1.36%)reached complete response,21 cases(28.77%)obtained partial response,45 cases(61.64%)had stable disease,and 6 cases(8.22%)experienced progressive disease.The overall objective response rate was 30.14%(22/73),and the overall disease control rate was 91.78%(67/73).The median PFS was 7.43 months(95%CI:4.78-10.09).The incidence of grade 1-2 immune related adverse reactions was 52.1%(38/73),and the incidence of grade 3-4 immune related adverse reactions was 11.0%(8/73).Conclusion In the real world,comprehensive treatment with PD-1 inhibitors for patients with advanced esophageal squamous cell carcinoma has good curative effect.It is a promising treatment,and the overall adverse reactions can be controlled.