信迪利单抗结合热放化疗治疗围绝经期宫颈癌效果及生存预后分析

Effect and survival prognosis of sindilizumab combined with thermoradiotherapy in the treatment of perimenopausal cervical cancer

目的探讨信迪利单抗结合热放化疗治疗围绝经期宫颈癌效果及生存预后分析。方法前瞻性选取2019年7月至2021年7月广西壮族自治区人民医院诊治的86例围绝经期宫颈癌患者为研究对象,采用随机双盲对照方法分为研究组和对照组,每组43例。对照组给予放化疗+热疗,研究组给予放化疗+热疗+信迪利单抗治疗。比较两组临床受益反应、不良反应、生存率及治疗前后血清表皮生长因子受体(EGFR)、人类表皮生长因子受体2(HER2)水平和程序性死亡受体1(PD-1)mRNA、程序性死亡配体1(PD-L1)mRNA表达水平。结果研究组治疗后客观缓解率(ORR)、疾病控制率(DCR)均高于对照组[55.82%(24/43)比32.56%(14/43)、69.77%(30/43)比48.84%(21/43)],差异有统计学意义(χ^(2)=4.71、3.90,P<0.05)。研究组治疗后体力明显恢复、体质量明显增加、疼痛明显减轻所占比例均高于对照组[67.44%(29/43)比41.86%(18/43)、58.14%(25/43)比30.23%(13/43)、67.44%(29/43)比44.19%(19/43)],差异有统计学意义(χ^(2)=5.68、6.79、4.72,P<0.05)。两组治疗后血清EGFR、HER2水平及PD-1 mRNA、PD-L1 mRNA表达均低于治疗前,研究组治疗前后EGFR、HER2差值及PD-1 mRNA、PD-L1 mRNA差值均大于对照组[(3.62±0.38)mg/L比(2.87±0.21)mg/L、(5.85±0.51)mg/L比(3.91±0.45)mg/L、0.55±0.08比0.34±0.05、0.19±0.05比0.13±0.04],差异有统计学意义(P<0.05)。两组治疗后不良反应发生率比较差异无统计学意义(P>0.05)。两组1年生存率比较差异无统计学意义(P>0.05)。结论信迪利单抗结合热放化疗有助于调节围绝经期宫颈癌患者EGFR、HER2水平,提高治疗效果,且安全性较好。

Objective:To investigate the effect of sindilizumab combined with thermoradiotherapy in the treatment of perimenopausal cervical cancer.Methods:Eighty-six patients with perimenopausal cervical cancer treatment in the People′s Hospital of Guangxi Zhuang Autonomous Region from July 2019 to July 2021 were perspectively selected and divided into the study group and the control group by random number table method,43 cases in each group.The control group was given chemoradiotherapy+hyperthermia,and the study group was given chemoradiotherapy+hyperthermia+sindillizumab.The clinical benefit reaction,adverse reaction,survival rate,serum levels of epidermal growth factor receptor(EGFR),human epidermal growth factor receptor 2(HER2),mRNA expression levels of programmed death receptor 1(PD-1)and programmed death ligand 1(PD-L1)before and after treatment were compared between the two groups.Results:The objective response rate(ORR)and disease control rate(DCR)in the study group were higher than those in the control group:55.82%(24/43)vs.32.56%(14/43),69.77%(30/43)vs.48.84%(21/43),there were statistical differences(χ^(2)=4.71,3.90,P<0.05).After treatment,the proportion of physical strength,body weight and pain relief in the study group were higher than those in the control group:67.44%(29/43)vs.41.86%(18/43),58.14%(25/43)vs.30.23%(13/43),67.44%(29/43)vs.44.19%(19/43),there were statistical differences(χ^(2)=5.68,6.79,4.72,P<0.05).The levels of serum EGFR,HER2,PD-1 mRNA and PD-L1 mRNA in the two groups after treatment were lower than those before treatment,and the differences of EGFR,HER2,PD-1 mRNA and PD-L1 mRNA before and after treatment in the study group were greater than those in the control group:(3.62±0.38)mg/L vs.(2.87±0.21)mg/L,(5.85±0.51)mg/L vs.(3.91±0.45)mg/L,0.55±0.08 vs.0.34±0.05,0.19±0.05 vs.0.13±0.04,there were statistical differences(P<0.05).There was no statistical difference in the incidence of toxic side effects between the two groups(P>0.05).The 1-year survival rate between the two groups had no statistical difference(P>0.05).Conclusions:Sindilizumab combined with thermoradiotherapy can help to modulate EGFR and HER2 in perimenopausal cervical cancer patients,and can improve the therapeutic effect with high safety.