卡瑞利珠单抗联合DNF化疗方案在晚期食管癌患者中的应用观察

Observation on the application of karelizumab combined with DNF chemotherapy in advanced esophageal cancer patients

目的:探讨卡瑞利珠单抗联合DNF化疗方案在晚期食管癌患者中的应用效果。方法:选择2021年6月—2022年12月本院收治的晚期食管癌患者96例,以随机数字表法分为两组,各48例。对照组行DNF化疗方案:静滴375 mg/m^(2)氟尿嘧啶+75 mg/m^(2)多西他赛+100 mg/m^(2)奈达铂,均在第1日使用,21 d为1个周期。观察组在此基础上加用200 mg卡瑞利珠单抗,第1日使用,21 d为1个周期。两组均治疗3个周期。比较两组疗效、肿瘤标志物、免疫指标、生活质量核心问卷量表(QLQ-C30)评分及毒副反应。结果:相比对照组,观察组治疗后疾病控制率、免疫功能指标均更高,差异有统计学意义(P<0.05)。两组治疗前鳞状上皮细胞癌相关抗原(SCC-Ag)、糖类抗原199(CA199)、细胞角蛋白19片段抗原21-1(CYFRA21H)、癌胚抗原(CEA)、免疫指标、功能、症状、总体健康状况等评分比较,差异无统计学意义(P>0.05);治疗后,两组SCC-Ag、CA199、CYFRA21H、CEA、功能、症状、总体健康状况等评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。两组毒副反应比较,差异无统计学意义(P>0.05)。结论:在化疗基础上,晚期食管癌患者加用卡瑞利珠单抗治疗利于提升抗肿瘤效果,发挥较好的抗肿瘤作用,促进患者免疫功能恢复,且不会增加毒副反应,患者生活质量得到明显提高,值得临床广泛应用。

Objective:To explore the application effect of Karelizumab combined with DNF chemotherapy in advanced esophageal cancer patients.Methods:96 patients with advanced esophageal cancer admitted to our hospital from June 2021 to Dec 2022 were selected and randomly divided into groups using a random number table method,with 48 patients in each group.The control group received DNF chemotherapy regimen:intravenous infusion of 375 mg/m^(2) fluorouracil+75 mg/m^(2) docetaxel+100 mg/m^(2) nedaplatin,all used on day 1,with 21 days as one cycle.Based on this,the observation group was additionally treated with 200 mg of Karelizumab,which was used on the 1st day and lasted for one cycle on the 21st day.Both groups were treated for 3 cycles.Compare the efficacy,tumor markers,immune indicators,Quality of Life Core Questionnaire(QLQ-C30),and toxic side effects between two groups.Results:Compared with the control group,the observation group had a higher disease control rate and immune function indicators after treatment,and the difference was statistically significant(P<0.05).There was no statistically significant difference(P>0.05)in the scores of squamous cell carcinoma associated antigen(SCC-Ag),carbohydrate antigen 199(CA199),cytokeratin 19 fragment antigen 21-1(CYFRA21H),carcinoembryonic antigen(CEA),immune indicators,function,symptoms,overall health status,and toxic side effects between the two groups before treatment.After treatment,the scores of SCC-Ag,CA199,CYFRA21H,CEA,function,symptoms,and overall health status in both groups decreased,and the observation group was lower than the control group,with statistical significance(P<0.05).Conclusions:On the basis of chemotherapy,the addition of Carolizumab to advanced esophageal cancer patients is beneficial for improving anti-tumor effects,exerting good anti-tumor effects,promoting immune function recovery,and not increasing toxic side effects.The quality of life of patients is significantly improved,which is worthy of widespread clinical application.