免疫联合化疗治疗肺鳞状细胞癌患者的效果与不良反应研究

Effects and adverse reactions of immunocombination chemotherapy in patients with lung squamous cell carcinoma

目的 分析免疫联合化疗治疗肺鳞状细胞癌(LUSC)患者的效果,为临床提供参考。方法 回顾性分析2020年1月至2023年1月北京市朝阳区桓兴肿瘤医院收治的118例LUSC患者的临床资料,根据治疗方案的不同将118例LUSC患者分为单药免疫组(13例)、单药化疗组(58例)和免疫联合化疗组(47例)。比较3组患者临床疗效、炎症因子[C反应蛋白(CRP)、降钙素原(PCT)和白细胞介素-6(IL-6)]水平、肿瘤标记物[鳞状细胞癌抗原(SCC)、癌胚抗原(CEA)和神经特异性烯醇化酶(NSE)]水平、肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))和呼气峰值流速(PEF)]水平和不良反应发生情况。结果 免疫联合化疗组患者的总有效率高于单药化疗组、单药免疫组(均P<0.05)。3组患者治疗完成后7d(T_(1))的CRP、PCT和IL-6水平均低于治疗前7d(T_(0)),且免疫联合化疗组均低于单药化疗组、单药免疫组(均P<0.05)。3组患者T_(1)的SCC、CEA和NSE水平均低于T_(0),且免疫联合化疗组的SCC和NSE水平均低于单药化疗组、单药免疫组(均P<0.05)。3组患者T_(1)的FVC、FEV_(1)和PEF水平均高于T_(0),免疫联合化疗组均高于单药化疗组、单药免疫组(均P<0.05)。单药化疗组患者的心肌炎、肝肾功能下降发生率均低于免疫联合化疗组、单药免疫组(均P<0.05)。结论 免疫联合化疗治疗LUSC患者的效果优于单药免疫和单药化疗,且可改善炎症反应及肺功能,降低肿瘤标记物水平。

Objective To analyze the efficacy of immunotherapy combined with chemotherapy in the treatment of lung squamous cell carcinoma(LUSC)patients,to provide clinical reference.Methods The clinical data of 118 patients with LUSC admitted to Beijing Chaoyang Huanxing Cancer Hospital from January 2020 to January 2023 were retrospectively analyzed.According to different treatment plans,118 LUSC patients were divided into the monotherapy immunotherapy group(13 cases),the monotherapy chemotherapy group(58 cases)and the immunotherapy combined chemotherapy group(47 cases).The clinical efficacy,levels of inflammatory cytokines[C-reactive protein(CRP),procalcitonin(PCT)and interleukin-6(IL-6)],levels of tumor markers[squamous cell carcinoma antigen(SCC),carcinoembryonic antigen(CEA)and neuro-specific enolase(NSE)],lung function indicators[forced vital capacity(FVC),forced expiratory volume at 1 second(FEV1)and peak expiratory flow rate(PEF)],and incidence of adverse reactions among 3 groups of patients were compared.Results The total effective rate of patients in the immunotherapy combined chemotherapy group was higher than that in the monotherapy chemotherapy group and monotherapy immunotherapy group(all P<0.05).The levels of CRP,PCT and IL-6 at 7 days after treatment completion(T_(1))in 3 groups were lower than 7 days before treatment(T_(0)),and the immune combined chemotherapy group were lower than that in the monotherapy chemotherapy group and monotherapy immunotherapy group(all P<0.05).The levels of SCC,CEA and NSE at T_(1) in 3 groups were lower than T_(0),and the level of SCC,CEA in the immune combined chemotherapy group were lower than that in the monotherapy chemotherapy group and monotherapy immunotherapy group(all P<0.05).The levels of FVC,FEV1 and PEF at T_(1) in 3 groups were higher than T_(0),and the immune combined chemotherapy group were higher than the other two groups(all P<0.05).The incidence of myocarditis and decreased liver and kidney function of the monotherapy chemotherapy group were lower than the other two groups(all P<0.05).Conclusion Immunotherapy combined with chemotherapy is more effective than monotherapy and monotherapy in treating LUSC patients,and can improve inflammatory response and lung function,reduce the level of tumor markers.