程序性细胞死亡蛋白-1抑制剂联合化疗治疗晚期肺腺癌的疗效

Clinical efficacy of programmed cell death receptor 1 inhibitor combined with chemotherapy in treating advanced lung adenocarcinoma

目的探究程序性细胞死亡蛋白-1(programmed cell death receptor 1,PD-1)抑制剂联合化疗治疗晚期肺腺癌(lung adenocarcinoma,LUAD)的临床疗效。方法回顾性分析98例晚期LUAD患者的临床资料,随机从予以化疗治疗(培美曲赛联合顺铂)的患者中抽取51例纳入对照组,从接受PD-1抑制剂(卡瑞利珠单抗)联合培美曲赛和顺铂治疗的患者中抽取47例纳入观察组,将2组患者按照倾向性匹配法进行匹配。记录2组患者的近期和远期临床疗效;比较2组治疗前及治疗后6个月时的肿瘤标志物[血清癌胚抗原(serum carcinoembryonic antigen,CEA)、组织多肽特异性抗原(tissue polypeptide specific antigen,TPS)、细胞角蛋白19片段抗原(cytokeratin 19 fragment antigen,CY-FRA21-1)]水平、免疫功能指标、肺功能差异;记录治疗期间2组患者不良反应的发生情况。结果治疗6个月后,2组疾病控制率比较差异无统计学意义(P>0.05),观察组的客观缓解率显著高于对照组(P<0.05);随访2年,观察组的生存率、无进展生存期、总生存时间均显著长于对照组(P<0.05);2组患者血清肿瘤标志物水平均显著降低,且观察组均低于对照组(P<0.05);2组的免疫功能指标、肺功能指标水平均显著升高,且观察组均高于对照组(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论对于晚期LUAD患者,进行PD-1抑制剂联合化疗治疗能够获得更高的近远期临床疗效,且安全性较好。

Objective To explore the clinical efficacy of programmed cell death receptor 1(PD-1)inhibitor combined with chemotherapy in the treatment of advanced lung adenocarcinoma(LUAD).Methods The clinical data of 98 patients with advanced LUAD in our hospital were retrospectively analyzed.51 patients were randomly selected from the clinical data of patients with chemotherapy(pemetrexed combined with cisplatin)and included into a control group,and 47 patients who were randomly collected from patients with PD-1 inhibitor(camrelizumab)combined with pemetrexed and cisplatin were enrolled as an observation group.The 2 groups of patients were matched according to the propensity matching method.The short-term and long-term clinical efficacy of the 2 groups were recorded.The levels of tumor markers[serum carcinoembryonic antigen(CEA),tissue polypeptide specific antigen(TPS),and cytokeratin 19 fragment antigen(CY-FRA21-1)],immune function indicators and lung function were compared before treatment and at 6 months after treatment.The toxic and side effects during treatment were recorded.Results After 6 months of treatment,no statistical significance was shown in disease control rate between groups(P>0.05),and the objective remission rate in observation group was significantly higher than that in the control group(P<0.05).After 2 years of follow-up,the survival rate,progression-free survival time and total survival time were significantly higher or longer in the observation group than those in control group(P<0.05).The levels of serum tumor markers in both groups were decreased significantly,and the observation group had lower levels(P<0.05).The levels of immune function indicators and lung function indicators were increased obviously,and the levels in observation group were higher(P<0.05).There was no statistical difference in the incidence rates of toxic and side effects between the 2 groups(P>0.05).Conclusion For patients with advanced LUAD,PD-1 inhibitor combined with chemotherapy can achieve high short-term and long-term clinical efficacy and has high safety.