TP或TC方案与GP方案分别联合信迪利单抗在晚期肺鳞癌一线治疗中的应用效果比较

Clinical evaluation of sintilimab combined with TP,TC or GP regimens in first-line treatment of advanced squamous cell lung cancer

目的比较TP或TC方案与GP方案分别联合信迪利单抗在晚期肺鳞癌一线治疗中的应用效果。方法回顾性分析2020年1月—2022年12月鹰潭市人民医院/南昌大学第一附属医院高新医院收治的新确诊85例晚期肺鳞癌患者临床资料,根据治疗方案不同分为观察组(n=49)和对照组(n=36)。观察组予TP或TC联合信迪利单抗方案治疗,对照组予GP联合信迪利单抗方案治疗。比较2组近期疗效、无进展生存期(PFS)、总生存期(OS)及不良反应并作分析。结果观察组与对照组客观缓解率(57.14%vs.50.00%)比较差异无统计学意义(χ^(2)=0.426,P=0.514);观察组与对照组疾病控制率(77.55%vs.72.22%)比较差异无统计学意义(χ^(2)=0.317,P=0.574)。观察组mPFS为7.5个月(95%CI:6.14~8.87),对照组mPFS为6.0个月(95%CI:4.73~7.27),组间无统计学差异(P=0.155)。观察组mOS为19.5个月(95%CI:15.66~23.34),对照组mOS为17.8个月(95%CI:16.63~18.97),组间无统计学差异(P=0.143)。观察组和对照组发生3~4级不良反应患者占比为40.82%和52.78%(χ^(2)=1.196,P=0.274);观察组发生血小板减少患者占比24.50%,对照组为47.22%(χ^(2)=4.771,P=0.029)。结论信迪利单抗联合白蛋白紫杉醇与铂类治疗方案兼具有效性与安全性,可推荐用于晚期肺鳞癌的一线治疗。

Objective To compare the efficacy of sintilimab combined with TP,TC or GP regimens in first-line treatment of advanced squamous cell lung cancer.Methods A retrospective analysis was conducted on the clinical data of 85 newly diagnosed advanced squamous cell lung cancer patients admitted to Yingtan City People′s Hospital and Gaoxin Hospital of the First Affiliated Hospital of Nanchang University from January 2020 to December 2022.Patients were divided into observation group(n=49)and control group(n=36)based on different treatment regimens.The observation group received treatment with sintilimab combined with either TP or TC regimen,while the control group received sintilimab combined with GP regimen.The study compared the short-term efficacy,progression-free survival(PFS),overall survival(OS),and adverse events between the two groups.Results There was no significant difference in overall response rate(ORR)between the observation group(57.14%)and the control group(50.00%)(χ^(2)=0.426,P=0.514).Similarly,there was no significant difference in disease control rate(DCR)between the two groups(77.55%vs.72.22%)(χ^(2)=0.317,P=0.574).The median progression-free survival(mPFS)was 7.5 months(95%CI:6.14~8.87)in the observation group and 6.0 months(95%CI:4.73~7.27)in the control group,with no significant difference between the two groups(P=0.155).The median overall survival(mOS)was 19.5 months(95%CI:15.66~23.34)in the observation group and 17.8 months(95%CI:16.63~18.97)in the control group,with no significant difference between the two groups(P=0.143).The incidence of grade 3~4 adverse events was 40.82%in the observation group and 52.78%in the control group(χ^(2)=1.196,P=0.274).The incidence of thrombocytopenia was 24.50%in the observation group,which was lower than that in the control group(47.22%)(χ^(2)=4.771,P=0.029).Conclusion The combination of sintilimab,albumin-bound paclitaxel,and platinum-based chemotherapy has demonstrated both efficacy and safety,and can be recommended as a first-line treatment option for advanced squamous cell lung cancer.