卡瑞利珠单抗联合同步放化疗治疗局部晚期非小细胞肺癌的临床分析

Clinical efficacy and safety of camrelizumab combined with concurrent chemoradiotherapy in patients with locally advanced non-small cell lung cancer

目的 比较卡瑞利珠单抗联合同步放化疗和单纯同步放化疗在局部晚期非小细胞肺癌(NSCLC)的治疗效果和不良反应差异。方法 选取62例安徽省胸科医院2020-01-01-2022-06-30经病理确诊的局部晚期NSCLC患者,随机分为对照组30例和观察组32例。对照组给予同步放化疗(顺铂+依托泊苷),观察组同步使用卡瑞利珠单抗免疫治疗。采用χ^(2)检验和Fisher检验比较两组患者临床病理特征、客观有效率(ORR)、ECOG评分和不良反应,使用生存分析比较两组患者无进展生存期(PFS)。使用Cox回归分析检验与预后相关因素。结果 两组患者临床病理特征差异无统计学意义,均P>0.05。对照组ORR为43.33%(13/30),观察组为71.88%(23/32),差异有统计学意义,χ^(2)=5.180,P=0.023。观察组6个月PFS率为84.38%,优于对照组的56.67%,差异有统计学意义,P=0.034。治疗后观察组ECOG评分低于对照组,P<0.001。两组患者治疗后不良反应分级均在3级以下,且未发生治疗相关致死事件。两组各不良反应发生率差异无统计学意义,P>0.05。结论 在局部晚期NSCLC患者中,采用同步放化疗联合卡瑞利珠单抗对比单纯同步放化疗,可显著改善患者近期疗效及预后,并且安全性良好。

Objective To explore the difference of the short-term efficacy and adverse reactions of camrelizumab combined with concurrent chemoradiotherapy versus concurrent chemoradiotherapy in patients with locally advanced non-small cell lung cancer(NSCLC).Methods A total of 62 patients first diagnosed with locally advanced NSCLC in our hospital were admitted in the study.Thirty patients who received intensity modulated radiotherapy combined with cisplatin plus etoposide regimen were divided into the control group, and the other 32 patients who received camrelizumab combined concurrent chemoradiotherapy were divided into the observation group, randomly.The χ^(2) test and Fisher test were used to compared the differences in the clinicopathological features, objective response rate(ORR),eastern cooperative oncology group(ECOG) score and adverse events.The Kaplan-Meier method was used to evaluate the progression-free survival(PFS) of two groups.The Cox regression analysis was used to explore the prognostic factors.Results There was no significant difference in clinicopathological features between the two groups(P>0.05).The ORR of the control group was 43.33%(13/30) and that of the observation group was 71.88%(23/32).The ORR of observation group was significantly higher than that of control group(χ^(2)=5.180,P=0.023).The 6-month PFS rate of observation group was significantly higher than that of control group(84.38% vs 56.67%,P=0.034).The ECOG score of observation group was significantly higher than that of control group after treatment(P<0.001).There were no Grade 3 or above adverse events and treatment-related fatal events occurred in the two groups.The incidence of adverse events between two groups had no significant difference(P>0.05).Conclusion In comparison with concurrent chemoradiotherapy alone,camrelizumab combined with concurrent chemoradiotherapy has reliable short-term efficacy,improved survival time and tolerable adverse reactions in locally advanced NSCLC patients.