晚期食管癌放疗后应用信迪利单抗对预后及不良反应的影响

Prognosis and Adverse Effects of Sindilizumab on Advanced Oesophageal Cancer after Radiotherapy

目的 探讨晚期食管癌患者放疗后应用信迪利单抗对临床预后及不良反应的影响。方法 回顾性分析53例晚期食管癌患者的临床资料,根据信迪利单抗治疗前是否接受放疗分为未放疗组(n=19)和放疗组(n=34)。收集患者入院时的临床资料、放疗及免疫放疗后效果、不良反应、无进展生存时间(progression free survival, PFS)、总生存时间(overall survival, OS)等。结果 放疗组的疾病控制率(disease control rate, DCR)55.88%(19/34),高于未放疗组的26.32%(5/19),差异有统计学意义(P<0.05),但2组总有效率差异无统计学意义(P>0.05)。放疗组的中位PFS和中位OS均高于未放疗组(中位PFS:8.0个月vs 6.5个月;中位OS:11.0个月vs 9.0个月),差异有统计学意义(均P<0.05)。未放疗组和放疗组间的不良反应发生率各个级别相近(1级78.9%vs 73.5%, 2级26.3%vs 29.4%,3级5.3%vs 8.8%),差异无统计学意义(P>0.05)。结论 晚期食管癌患者中信迪利单抗治疗前接受放疗的患者PFS和OS较未放疗组患者有明显获益,未增加不良反应。

Objective To investigate the efficacy and safety of Sintilizumab in patients with advanced esophageal cancer.Methods We retrospectively analyzed the clinical data of 53 patients with advanced esophageal cancer.The patients were divided into non-radiotherapy group(n=19)and radiotherapy group(n=34)according to whether they received radiotherapy before Sintilimab treatment.Clinical information on admission,efficacy and adverse effects after radiotherapy and immunoradiotherapy,progression free survival(PFS)and overall survival(OS)were collected.Results The disease control rate in the radiotherapy group was 55.88%(19/34),which was higher than the 26.32%(5/19)in the non-radiotherapy group,with statistically significant difference(P<0.05),but the difference in the total effective rate between the 2 groups was not statistically significant(P>0.05).Median PFS and median OS were both higher in the radiotherapy group than in the non-radiotherapy group(median PFS:8.0months vs 6.5 months;median OS:11.0 months vs 9.0 months),with statistically significant differences(both P<0.05).The incidence of adverse reactions was similar between the non-radiotherapy and radiotherapy groups at all levels(Grade 178.9%vs 73.5%,Grade 226.3%vs 29.4%,Grade 35.3%vs 8.8%)and the difference was not statistically significant(P>0.05).Conclusion Patients with advanced oesophageal cancer who receive radiotherapy prior to cedilizumab treatment may have a significant benefit in PFS and OS compared to patients in the non-radiotherapy group,without increased adverse effects.