PD-1单抗联合白蛋白紫杉醇+奈达铂化疗治疗局部晚期食管癌的效果研究

Study on the Efficacy of PD-1 Monoclonal Antibody Combined with Albumin-Bound Paclitaxel and Nedaplatin Chemotherapy in the Treatment of Locally Advanced Esophageal Cancer

目的研讨局部晚期食管癌采用程序性死亡受体1(PD-1)单抗、白蛋白紫杉醇^(+)奈达铂化疗治疗的效果。方法选择中国人民解放军联勤保障部队第九八九医院2021年1月至2023年6月收入的60例局部晚期食管癌患者,根据治疗方案不同分成两组,各30例。对照组给予白蛋白紫杉醇^(+)奈达铂化疗治疗,观察组给予卡瑞利珠单抗联合白蛋白紫杉醇^(+)奈达铂化疗治疗,比较两组治疗效果。结果观察组近期客观缓解率(80.00%)高于对照组(50.00%),差异有统计学意义(P<0.05),观察组近期疾病控制率(100.00%)与对照组(93.33%)比较,差异无统计学意义(P>0.05);治疗后观察组癌胚抗原(CEA)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原19-9(CA19-9)、鳞状细胞癌相关抗原(SCC-Ag)水平均低于对照组,差异有统计学意义(P<0.05);治疗后观察组T细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))指标均高于对照组,差异有统计学意义(P<0.05);治疗后观察组PD-1、程序性死亡受体配体1(PD-L1)水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率对比差异无统计学意义(P>0.05)。结论局部晚期食管癌采取PD-1单抗、白蛋白紫杉醇^(+)奈达铂化疗治疗效果明显,能减低肿瘤标志物水平,提升机体免疫功能,调节PD-1、PD-L1水平,且安全性较高。

Objective To investigate the efficacy of programmed death receptor 1(PD-1)monoclonal antibody combined with albumin-bound paclitaxel and nedaplatin chemotherapy in the treatment of locally advanced esophageal cancer.Methods Sixty patients with locally advanced esophageal cancer admitted to The 989th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army from January 2021 to June 2023 were selected and divided into two groups based on different treatment regimens,with 30 cases in each group.The control group received albumin-bound paclitaxel and nedaplatin chemotherapy,while the observation group received camrelizumab combined with albumin-bound paclitaxel and nedaplatin chemotherapy.The treatment effects of the two groups were compared.Results The short-term objective response rate(80.00%)in the observation group was higher than that in the control group(50.00%),with statistically significant differences(P<0.05).There was no statistically significant difference in the short-term disease control rate between the observation group(100.00%)and the control group(93.33%)(P>0.05).After treatment,the levels of carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carbohydrate antigen 19-9(CA19-9),and squamous cell carcinoma antigen(SCC-Ag)in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the T cell subsets(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).After treatment,the levels of PD-1 and programmed death-ligand 1(PD-L1)in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of PD-1 monoclonal antibody,albumin-bound paclitaxel,and nedaplatin chemotherapy is effective in treating locally advanced esophageal cancer.It can reduce tumor marker levels,enhance immune function,regulate PD-1 and PD-L1 levels,and has a high safety profile.