新辅助免疫治疗联合化疗对局部晚期非小细胞肺癌的安全性及疗效

Safety and efficacy of neoadjuvant immunotherapy combined with chemotherapy for locally advanced non-small cell lung cancer

目的:探讨新辅助免疫治疗联合化疗对局部晚期非小细胞肺癌的安全性及疗效。方法:回顾性纳入2020年12月1日至2022年12月1日在川北医学院附属医院胸外科接受新辅助免疫联合化疗的局部晚期非小细胞肺癌患者36例,每21天为1个治疗周期,治疗过程中评估安全性及每个周期后评价疗效。结果:影像学疗效评价客观缓解率(ORR)为86.1%,疾病控制率(DCR)为91.7%。其中完全缓解(CR)5例(13.8%),部分缓解(PR)26例(72.2%),疾病稳定(SD)2例(5.6%),疾病进展(PD)3例(8.3%)。30例为R0切除,手术切除率为83.3%。全组患者的不良反应主要为1、2级,最常见的为脱发、皮疹、转氨酶升高、甲减、白细胞减少、中性粒细胞减少、血小板减少及消化道反应如恶心、呕吐、腹泻、便秘。发生3级不良反应患者仅3例,无4级不良反应发生。结论:新辅助免疫治疗联合化疗对局部晚期非小细胞肺癌有良好的安全性及疗效,值得更进一步的探索研究。

Objective:To investigate the safety and efficacy of neoadjuvant immunotherapy combined with chemotherapy for locally advanced non-small cell lung cancer.Methods:36 patients with locally advanced non-small cell lung cancer who received neoadjuvant immunotherapy combined with chemotherapy in the Department of Thoracic Surgery,Affiliated Hospital of North Sichuan Medical College from December 1,2020 to December 1,2022 were retrospectively included in this study.Results:The objective response rate(ORR)and disease control rate(DCR)were 86.1%and 91.7%,respectively.Among them,5 patients(13.8%)had complete response(CR),26 patients(72.2%)had partial response(PR),2 patients(5.6%)had stable disease(SD),and 3 patients(8.3%)had progressive disease(PD).30 patients were R0 resection,and the surgical resection rate was 83.3%.Adverse reactions in the whole group were mainly grade 1 and 2,and the most common adverse reactions were alopecia,rash,elevated transaminases,hypothyroidism,leukopenia,neutropenia,thrombocytopenia and gastrointestinal reactions such as nausea,vomiting,diarrhea,and constipation.Grade 3 adverse reactions occurred in only 3 patients,and no grade 4 adverse reactions occurred.Conclusion:Neoadjuvant immunotherapy combined with chemotherapy has good safety and efficacy in locally advanced non-small cell lung cancer,which is worthy of further exploration.