摘要
目的 免疫联合化疗的新辅助免疫治疗可起到协调杀伤肿瘤细胞的作用,但在免疫激活的过程中出现的免疫失衡可导致免疫相关不良事件(immune-related adverse events, IRAEs)的产生,通过案例分析探讨如何制定有效的治疗IRAEs方案具有明显的临床意义。方法 确诊的膀胱癌病人2例,均接受特瑞普利单抗和吉西他滨(gemcitabine)、顺铂(carbamazepine)(GC方案)新辅助治疗。结果 2例病人的病情有缓解,均发生免疫相关性膀胱炎,应用类固醇后迅速改善,行机器人辅助腹腔镜下根治性膀胱切除术+回肠代膀胱术,术后随访,预后均较好。结论 新辅助免疫治疗可用于治疗膀胱癌,一旦发生免疫相关性膀胱炎等IRAEs,及时制定合理的治疗方案对改善预后至关重要。
Objective The neoadjuvant immunotherapy of immune combined chemotherapy can coordinate and kill tumor cells. However, the immune imbalance in the process of immune activation can lead to immune-related adverse events(IRAEs). It has obvious clinical significance to explore how to develop an effective treatment plan for IRAEs through case analysis.Methods 2 cases bladder cancer patients who received neoadjuvant therapy of teriprizumab, gemcitabine and carbamazepine(GC regimen). Result 2 patients got remission after trtatment, but got immune-related bladder inflammation. After treatment of steroids, patients immune-related bladder inflammation symptoms had improved. Robot-assisted laparoscopy laparoscopic radical cystectomy and ileal bladder replacement was performed. 2 patients were followed up, their prognosis were good. Conclusion Neoadjuvant immunotherapy can be used to treat bladder cancer. Once immune-related bladder inflammation or other IRAEs occur, it is important to formulate a reasonable treatment plan in time to improve the prognosis of patients.
作者
张顺
丁秋播
庄君龙
ZHANG Shun;DING Qiubo;ZHUANG Junlong(Department of Urology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210000,China)
出处
《临床外科杂志》
2022年第3期276-279,共4页
Journal of Clinical Surgery
基金
江苏省自然科学基金优秀青年基金资助项目(BK20200051)。
