信迪利单抗联合白蛋白结合型紫杉醇和顺铂治疗EGFR突变阴性非小细胞肺癌的效果

Efficacy of Sintilimab Combined with Albumin Binding Type Paclitaxel and Cisplatinin the Treatment of EGFR Mutation Negative Non-small Cell Lung Cancer

目的分析信迪利单抗联合白蛋白结合型紫杉醇和顺铂治疗表皮生长因子受体(EGFR)突变阴性非小细胞肺癌(NSCLC)的效果。方法前瞻性纳入120例EGRF突变阴性NSCLC患者(2021年3月至2023年3月收治),随机分为两组。对照组接受白蛋白结合型紫杉醇联合顺铂,观察组加用信迪利单抗,各60例。均化疗3个周期。比较两组疗效和不良反应发生率、细胞生长因子(VEGF)水平、肿瘤标志物水平、T淋巴细胞亚群(CD4^(+)、CD8^(+))。结果观察组临床客观缓解率高于对照组(P<0.05)。治疗后,相较于对照组,观察组的细胞生长因子指标水平及肿瘤标志物水平较低(P<0.05);且观察组的CD4^(+)较高、CD8^(+)较低(P<0.05)。两组患者不良反应发生率差异无统计学意义(P>0.05)。结论信迪利单抗联合白蛋白结合型紫杉醇和顺铂治疗EGFR突变阴性NSCLC能够提高整体化疗效果,抑制细胞因子的生成和肿瘤标志物的表达,减少因化疗药物带来的免疫抑制,且不会增加药物不良反应。

Objective To investigate the efficacy of sintilimab combined with albumin binding type paclitaxel and cisplatin in the treatment of epidermal growth factor receptor(EGFR)mutation negative non-small cell lung cancer(NSCLC).Methods A total of 120 NSCLC patients with negative EGRF mutation(admitted from March 2021 to March 2023)were prospectively included and randomly divided into two groups.The control group received a combination of albumin binding type paclitaxel and cisplatin,while the observation group received an additional dose of sintilimab and received chemotherapy for three cycles,60 cases in each group.The efficacy and incidence of adverse reactions,levels of cell growth factor(VEGF),levels of tumor markers,and T lymphocyte subsets(CD4^(+),CD8^(+))were compared in both groups.Results Compared with control group,the clinical objective response rate of the observation group was higher(P<0.05).After treatment,compared to the control group,the observation group had lower levels of cell growth factor indicators and tumor markers(P<0.05).And the CD4^(+)in the observation group was higher,while the CD8^(+)was lower(P<0.05).There was no difference in the incidence of adverse reactions between the two groups of patients(P>0.05).Conclusion Sintilimab combined with albumin binding type paclitaxel and cisplatin in the treatment of EGFR mutated negative NSCLC can improve the overall chemotherapy effect,inhibit the generation of cytokines and the expression of tumor markers,reduce immune suppression caused by chemotherapy drugs,and do not increase drug toxicity.