尼妥珠单抗辅助治疗中晚期宫颈癌患者的疗效及其对外周血NLR、PLR的影响

Effi cacy of Adjuvant Therapy with Nimotuzumab and its Effects on Peripheral Blood NLR and PLR in Patients with Advanced Cervical Cancer

目的:探讨尼妥珠单抗辅助治疗中晚期宫颈癌患者的疗效及其对外周血中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)的影响。方法:选取2016年8月~2018年10月本院收治的84例宫颈癌(ⅡB~ⅣA期)患者为研究对象,根据治疗方案的不同分为对照组(n=40)与观察组(n=44)。对照组给予化疗治疗与放射治疗,观察组在对照组治疗基础上加用尼妥珠单抗靶向治疗。比较两组患者近期疗效、肿瘤退缩情况、外周血NLR和PLR水平、不良反应发生情况以及3年内生存率。结果:治疗后,观察组治疗总有效率(97.73%)高于对照组(85.00%,P<0.05)。治疗前两组肿瘤体积无统计学差异(P>0.05);治疗2周后和治疗5周后两组肿瘤体积均明显缩小,且观察组肿瘤体积小于对照组(P<0.05)。治疗前两组NLR、PLR水平均无统计学差异(P>0.05);治疗后两组NLR、PLR水平均明显降低,且观察组低于对照组(P<0.05)。治疗期间,两组均出现了白细胞减少、恶心呕吐、放射性直肠炎和膀胱炎等不良反应,但两组比较无统计学差异(P>0.05)。为期3年的随访数据显示,观察组1年、2年、3年生存率分别为95.45%、86.36%、77.27%,对照组1年、2年、3年生存率分别为90.00%、77.50%、62.50%,两组3年内生存率比较均无统计学差异(P>0.05)。结论:尼妥珠单抗辅助治疗中晚期宫颈癌患者能有效提高近期疗效,加速肿瘤细胞凋亡、使肿瘤退缩,还可使患者外周血NLR、PLR下降,且安全性良好。

Objective:To investigate the efficacy of adjuvant therapy with nimotuzumab and its effects on peripheral blood neutrophil-to-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)in patients with advanced cervical cancer.Methods:A total of 84 patients with cervical cancer(PhaseⅡB~ⅣA)admitted to our hospital from August 2016 to October 2018 were selected as the research subjects,and were grouped according to the time of admission.40 patients admitted from August 2016 to August 2017 were included in the control group,and 44 patients admitted from September 2017 to October 2018 were included in the observation group.The control group was treated with chemotherapy and radiotherapy,while the observation group was treated with nimotuzumab on the basis of the control group.The shortterm efficacy,tumor regression,peripheral blood NLR and PLR levels,adverse reactions and 3-year survival rate were compared between the two groups.Results:After treatment,the total effective rate of the observation group(97.73%)was higher than that of the control group(85.00%,P<0.05).There was no significant difference in tumor volume between the two groups before treatment(P>0.05).After 2 weeks and 5 weeks of treatment,the tumor volume in both groups decreased significantly(P<0.05),and the tumor volume in the observation group was smaller than that in the control group(P<0.05).There was no significant difference in NLR and PLR between the two groups before treatment(P>0.05);after treatment,the levels of NLR and PLR in the two groups decreased significantly,and those in the observation group were significantly lower than those in the control group(P<0.05).During the treatment,adverse reactions such as leukopenia,nausea and vomiting,radiation proctitis and cystitis occurred in both groups,but there was no significant difference between the two groups(P>0.05).After 3-year follow-up,the 1-year,2-year and 3-year survival rates of the observation group were 95.45%,86.36%and 77.27%respectively,and the 1-year,2-year and 3-year survival rates of the control group were 90.00%,77.50%and 62.50%respectively.There was no statistical difference between the two groups in the 3-year survival rates(P>0.05).Conclusion:Nimotuzumab can effectively improve the short-term efficacy,accelerate tumor cell apoptosis,shrink the tumor,and reduce the peripheral blood NLR and PLR level in patients with advanced cervical cancer.And it has better safety.