抗生素对晚期尿路上皮癌化疗联合免疫治疗疗效的影响

The effect of antibiotics on chemotherapy combined with immunotherapy of advanced urothelial carcinoma

目的 探讨抗生素对晚期尿路上皮癌患者行化疗联合免疫治疗期间临床疗效的影响。方法 选取2020年8月至2022年12月在我院确诊为晚期尿路上皮癌且行化疗联合免疫治疗的71例患者进行回顾性分析,根据是否应用抗生素分为应用抗生素(A)组和未应用抗生素(B)组,分别比较两组的基线特征及生存分析等。结果 两组患者的基线临床资料差异无统计学意义(P>0.05)。应用抗生素(A)组患者mPFS为6个月(95%CI:4.92~7.08),与未应用抗生素(B)组的8个月(95%CI:5.67~10.34)相比显著降低(P=0.001),多因素Cox回归分析显示抗生素应用情况是患者PFS(HR=2.11,95%CI:1.17~3.81,P=0.014)的独立影响因素。结论 抗生素可以影响晚期尿路上皮癌患者化疗联合免疫治疗的临床疗效,使患者的无进展生存期(PFS)缩短,在临床中应慎重合理应用抗生素。

Objective This study aimed to investigate the influence of antibiotics on the clinical efficacy of chemotherapy combined with immunotherapy in patients with advanced urothelial carcinoma.Methods A retrospective analysis was conducted on 71 patients diagnosed with advanced urothelial carcinoma who received chemotherapy combined with immunotherapy in our hospital between August 2020 and December 2022.The patients were divided into two groups:Group A(patients who received antibiotics)and Group B(patients who did not receive antibiotics).The baseline characteristics and survival analyses were compared between the two groups.Results There were no statistically significant differences in baseline clinical characteristics between the two groups(P>0.05).The median progression-free survival(mPFS)in Group A was 6 months(95%CI:4.92-7.08),which was significantly lower compared to 8 months(95%CI:5.67-10.34)in Group B(P=0.001).Multivariate Cox regression analysis demonstrated that the use of antibiotics was an independent factor affecting PFS(HR=2.11,95%CI 1.17-3.81,P=0.014).Conclusion Antibiotics can impact the clinical efficacy of chemotherapy combined with immunotherapy in patients with advanced urothelial carcinoma,resulting in shortened progression-free survival(PFS).Therefore,the use of antibiotics should be cautiously and appropriately considered in clinical practice.