免疫治疗联合热疗加放疗治疗老年中晚期宫颈癌的疗效及安全性

Efficacy and safety of immunotherapy combined with hyperthermia and radiotherapy in the treatment of advanced cervical cancer in the elderly

目的:探讨老年中晚期宫颈癌免疫治疗联合热疗加放疗的疗效及安全性。方法:前瞻性分析我院2020年01月至2021年06月期间的老年中晚期宫颈癌患者免疫治疗联合热疗加放疗(热免疫放疗组)对比热疗联合同步放化疗(热放化疗组)的临床疗效和相关毒副反应。结果:共分析了56例患者,热免疫放疗组和热放化疗组ORR率分别为73.08%(19/26)和86.67%(26/30);PFS分别为53.8%(14/26)和56.7%(17/30);OS分别为61.5%(16/26)和66.7%(20/30),均无统计学差异。两组胃肠道毒性(恶心、呕吐、便秘等)、肝功能损伤、肾功能损伤、放射性膀胱炎之间无差异(P>0.05)。热免疫放疗组中血液学毒性的发生率(粒细胞减少、贫血、血小板减少)较热放化疗组明显降低(P<0.05);热免疫放疗组中>1级放射性直肠炎的发生率较热放化疗组明显降低(P<0.05)。结论:免疫治疗联合热疗加放射治疗模式治疗老年中晚期宫颈癌疗效显著,且不增加治疗相关毒副反应,有效且安全,或许能成为老年中晚期宫颈癌的治疗新选择。

Objective:To investigate the efficacy and safety of immunotherapy combined with hyperthermia and radiotherapy for middle-advanced cervical cancer in the elderly.Methods:The clinical efficacy of immunotherapy,hyperthermia and radiotherapy in elderly patients with middle-advanced cervical cancer during the period from January 2020 to June 2021 in our hospital was prospectively analyzed,and the related side effects were compared with the efficacy of hyperthermia plus standard concurrent radiotherapy and chemotherapy.Results:A total of 56 patients were analyzed.The ORR rates of the thermoimmunoradiotherapy group and the thermoradiochemotherapy group were 73.08%(19/26) and 86.67%(26/30),respectively.PFS were 53.8%(14/26) and 56.7%(17/30) respectively.OS were 61.5%(16/26) and 66.7%(20/30) respectively,with no statistical difference.There was no difference between the two groups in gastrointestinal toxicity(nausea,vomiting,constipation,etc.),liver function damage,renal function damage,and radiation cystitis(P>0.05).The incidence of hematological toxicity(granulocytopenia,anemia,thrombocytopenia) in the thermoimmunotherapy group was significantly lower than that in the thermoradiochemotherapy group(P<0.05).The incidence of radiation proctitis>grade 1 in the thermoimmunotherapy group was significantly lower than that in the thermoradionchemotherapy group(P<0.05).Conclusion:The combination of immunotherapy and hyperthermia with radiation therapy has a significant therapeutic effect in elderly patients with advanced cervical cancer,and does not increase treatment-related toxic side effects.It is effective and safe.Perhaps it can become a new choice for the treatment of advanced cervical cancer in the elderly.