程序性死亡受体-1抑制剂联合化疗治疗晚期非小细胞肺癌

Programmed death receptor-1 inhibitors and chemotherapy for advanced non-small cell lung cancer patients

目的 探究程序性死亡受体-1抑制剂(programmed death receptor-1,PD-1)联合化疗在晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)治疗中的疗效。方法 以区组随机化分组为分组依据,将本院2019年2月—2020年2月收治的90例晚期NSCLC患者分为干预组(PD-1联合白蛋白紫杉醇+顺铂治疗)与参照组(白蛋白紫杉醇+顺铂治疗)各45例,对干预效果进行分析比较。结果 干预组治疗总有效率为73.33%,明显高于参照组的53.33%,差异有统计学意义(P<0.05)。治疗前两组细胞免疫指标比较,差异无统计学意义(P>0.05),治疗后干预组CD3^(+)、CD4^(+)均高于参照组,CD8^(+)低于参照组,差异有统计学意义(P<0.05)。治疗前两组炎症因子水平比较,差异无统计学意义(P>0.05),治疗后干预组均低于参照组,差异有统计学意义(P<0.05)。干预组不良反应发生率为44.44%,参照组为48.88%,差异无统计学意义(P>0.05)。干预组一年生存率为60.00%,显著高于参照组的37.78%,差异有统计学意义(P<0.05)。治疗前两组生活质量(quality of life,QOL)评分差异无统计学意义(P>0.05),治疗后干预组评分均高于参照组,差异有统计学意义(P<0.05)。结论 将PD-1抑制剂联合化疗应用于晚期NSCLC患者,可显著提高其免疫力,降低炎症因子水平且不良反应少、安全性高、生活质量提升显著,疗效确切。

Objective:To investigate the efficacy,survival and adverse reactions of programmed death-1 inhibitor(PD-1)combined with chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC).Methods:Based on random sampling method,90 patients with advanced NSCLC treated in Longyan First Hopsital,Fujian Medical University were divided into the intervention group(PD-1 combined with nab-paclitaxel+cisplatin treatment)and the reference group(nab-paclitaxel+cisplatin treatment)with 45 cases in each group,and all received treatment in our hospital from Febrary 2019 to Febrary 2020,and the effect of intervention was analyzed and compared.Results:The total effective rate of the intervention group was 73.33%,which was significantly higher than 53.33% of the reference group;before the therapy,the cell immune indicators between groups were not significantly different(P>0.05);After treatment,the CD3and CD4levels of the intervention group were higher.In the reference group,CD8was lower than that in the reference group(P<0.05);The levels of inflammatory factors in the two groups before treatment were basically the same(P>0.05);After treatment,the intervention group was lower than the reference group(P<0.05).The incidence of adverse reactions in the intervention group was 44.44 %,which was not significantly different from 48.88% in the reference group(P>0.05);The one-year survival rate in the intervention group was 60.00%,which was significantly higher than 37.78% in the reference group,with a significant difference(P<0.05).There was no difference in the quality of life(QOL)scores in the two groups before treatment(P>0.05),and the scores in the intervention group were higher than those in the reference group after treatment(P<0.05).Conclusion:PD-1 inhibitors and chemotherapy can reduce the level of inflammatory factors and adverse reactions,and improve the immune function,treatment safety and quality of life for advanced NSCLC patients.