卡瑞利珠单抗对晚期宫颈癌患者血清肿瘤标志物及生活质量的影响

Influence of camrelizumab on serum tumor markers and quality of life in patients with advanced cervical cancer

目的:探讨卡瑞利珠单抗对晚期宫颈癌患者血清肿瘤标志物及生活质量的影响。方法:以随机数字表法将2022年2月—2023年2月本院收治的晚期宫颈癌患者80例分成两组,每组40例。对照组予以同期放化疗,使用医学直线加速器6 MV X线适形调强放疗,照射剂量根据患者情况进行合理选择,不同部位照射剂量有所差异,如盆腔内以及腹膜后淋巴结阳性为60 Gy,盆腔外45~50.4 Gy,5次/周;化疗方法:在放疗开始后的第1、4、7周进行,21 d为1个周期,连续进行3个周期,使用30 mg/m^(2)顺铂+135 mg/m^(2)紫杉醇,紫杉醇于第1日使用,顺铂于第2~4日使用。基于此,观察组加用200 mg卡瑞利珠单抗治疗,于顺铂使用后间隔1 d用药,21 d用1次。比较两组近期疗效、肿瘤标志物[鳞状上皮细胞癌相关抗原(SCC-Ag)、糖类抗原199(CA199)、细胞角蛋白19片段(CYFRA21H)、糖类抗原125(CA125)]、生活质量及毒副反应。结果:观察组疾病控制率为85.00%(34/40)高于对照组的60.00%(24/40),差异有统计学意义(P<0.05)。两组治疗前SCC-Ag、CA199、CYFRA21H、CA125、癌症患者生命质量共性部分的量表(FACT-G)与宫颈癌分量表(CxCS)评分比较,差异无统计学意义(P>0.05);治疗后,两组SCC-Ag、CA199、CYFRA21H和CA125均降低,FACT-G和CxCS评分均升高,且观察组变化更明显,差异有统计学意义(P<0.05)。两组毒副反应比较,差异无统计学意义(P>0.05)。结论:晚期宫颈癌患者采用卡瑞利珠单抗治疗效果较好,能够提高疾病控制率与患者生存质量,降低肿瘤标志物水平,且不会增加毒副反应,临床应用安全可靠。

Objective:To explore the influence of camrelizumab on serum tumor markers and quality of life in patients with advanced cervical cancer.Methods:Eighty patients with advanced cervical cancer admitted to our hospital between February 2022 and February 2023 were divided into two groups the random number table method,with 40 patients in each group.The control group received concurrent chemoradiotherapy.Medical linear accelerator 6 MV X-ray conformal intensity-modulated radiotherapy was used.The irradiation dose was selected based on the patient's condition.The irradiation doses for different parts were different.For example,the positive pelvic and retroperitoneal lymph nodes received 60 Gy,and the outside of the pelvis received 45~50.4 Gy,5 times a week.Chemotherapy method:This was performed in the 1st,4th,and 7th weeks after the start of radiotherapy.A total of 21 days were used as a cycle,and three consecutive cycles were performed.Use of 30 mg/m^(2) cisplatin+135 mg/m^(2) paclitaxel.Paclitaxel was administered on the first day and cisplatin was used on the 2nd to 4th days.Based on this,the observation group was treated with 200 mg of camrelizumab.The drug was administered one day after cisplatin administration and once every 21 days thereafter.The short-term efficacy,tumor markers[squamous cell carcinoma-associated antigen(SCC-Ag),carbohydrate antigen 199(CA199),cytokeratin 19 fragment(CYFRA21H),carbohydrate antigen 125(CA125)],quality of life,and toxicity and side effects were compared between the two groups.Results:The disease control rate in the observation group was 85.00%(34/40),which was higher than that in the control group(60.00%,24/40).The difference was statistically significant(P<0.05).There were no statistically significant differences in SCC-Ag,CA199,CYFRA21H,CA125,Functional Assessment of Cancer Therapy-General(FACT-G),or Cervical Cancer Subscale(CxCS)scores of cancer patients before treatment between the two groups(P>0.05).After treatment,SCC-Ag,CA199,CYFRA21H,and CA125 levels in both groups decreased,and the FACT-G and CxCS scores increased.Changes in the observation group were more obvious.The difference was statistically significant(P<0.05).There were no statistically significant differences in toxicity and side effects between the two groups(P>0.05).Conclusion:Camrelizumab is effective for the treatment of patients with advanced cervical cancer.It can improve the disease control rate and quality of life of patients,reduce the level of tumor markers,and will not increase toxicity and side effects.Thus,it is safe and reliable for clinical application.