免疫治疗联合贝伐珠单抗抗血管生成双靶治疗对老年晚期肺腺癌患者近期临床疗效及安全性的影响

Short-Term Clinical Efficacy and Safety of Immunotherapy Combined with Anti-Angiogenic Dual-Target Therapy in the Treatment of Elderly Patients with Advanced Lung Adenocarcinoma

目的探讨免疫治疗联合贝伐珠单抗抗血管生成双靶治疗对老年晚期肺腺癌患者近期临床疗效、免疫功能及安全性的影响。方法选取医院2022年4月至12月收治的年龄不低于60岁的Ⅳ期肺腺癌患者60例,随机分为联合组和对照组,各30例。两组患者均予标准化学治疗联合卡瑞利珠单抗或信迪利单抗治疗,联合组患者加用贝伐珠单抗,两组患者均治疗9周。结果联合组客观缓解率为36.67%,显著高于对照组的13.33%(P<0.05);疾病控制率为86.67%,高于对照组的73.33%,但差异无统计学意义(P>0.05)。治疗后,两组患者T淋巴细胞亚群CD3^(+),CD4^(+)水平及CD4^(+)/CD8^(+)均显著升高(P<0.05),CD8^(+)水平均显著降低(P<0.05),且联合组变化均更显著(P<0.05);两组患者卡氏功能状态(KPS)评分均显著升高(P<0.05),且联合组升高更显著(P<0.05);联合组患者KPS评分变化等级为增加的占90.00%,显著高于对照组的66.67%(P<0.05)。联合组和对照组患者消化道反应、骨髓移植、肝肾功能损伤、血液毒性及周围神经毒性发生率均相当(P>0.05)。结论免疫治疗联合贝伐珠单抗抗血管生成双靶治疗老年晚期肺腺癌的近期临床疗效良好,可改善患者的免疫功能,提高健康状况,且安全性良好。

Objective To investigate the effect of immunotherapy combined with anti-angiogenic dual-target therapy on the short-term clinical efficacy,immune function,and clinical safety in elderly patients with advanced lung adenocarcinoma.Methods Sixty patients(≥60 years)with stageⅣlung adenocarcinoma admitted to the hospital from April to December 2022 were selected and randomly divided into the combination group and the control group,with 30 cases in each group.The patients in the two groups were treated with standard chemotherapy combined with either carrilizumab or xindirizumab,on this basis,the patients in the combination group were treated with bevacizumab.Both groups were treated for 9 weeks.Results The objective response rate(ORR)in the combination group was 36.67%,which was significantly higher than 13.33%in the control group(P<0.05).The disease control rate(DCR)in the combination group was 86.67%,which was higher than 73.33%in the control group,but the difference was not statistically significant(P>0.05).After treatment,the T lymphocyte subsets CD3^(+),CD4^(+)levels,and CD4^(+)/CD8^(+)significantly increased(P<0.05),while the CD8^(+)level significantly decreased in the two groups(P<0.05),and the change in the combination group was more significant than that in the control group(P<0.05);the Karnofsky function(KPS)score in the two groups significantly increased(P<0.05),and that in the combination group was significantly higher than that in the control group(P<0.05);the proportion of KPS score change with an increase level in the combination group was 90.00%,which was significantly higher than 66.67%in the control group(P<0.05).The incidence rates of gastrointestinal reactions,bone marrow transplantation,liver and kidney function damage,hematotoxicity,and peripheral neurotoxicity between the two groups were comparable(P>0.05).Conclusion Immunotherapy combined with anti-angiogenic dual-target therapy in the treatment of elderly patients with advanced lung adenocarcinoma has good short-term clinical efficacy and safety,which can significantly improve the patient's immune function and health status.