摘要
目的探讨信迪利单抗联合紫杉醇、多西他赛二线治疗晚期非小细胞肺癌(NSCLC)的效果。方法前瞻性队列研究。前瞻性选取包头市肿瘤医院2019年10月至2022年10月收治的90例二线治疗晚期NSCLC患者,采用随机数字表法分为研究组(信迪利单抗联合紫杉醇或多西他赛二线治疗,45例)和对照组(单纯紫杉醇或多西他赛二线治疗,45例)。比较两组患者的近期疗效、血清细胞因子水平、生命质量和T细胞亚群等;获取随访6个月内患者生存情况,采用Kaplan-Meier法分析两组总生存(OS),组间比较行log-rank检验。结果研究组和对照组患者年龄分别为(63±5)岁、(65±6)岁,分别有男性25例(55.56%)、28例(62.22%),两组性别、年龄、美国东部肿瘤协作组评分、体质量差异均无统计学意义(均P>0.05),具有可比性。研究组总有效率为88.89%(40/45),对照组为71.11%(32/45),差异有统计学意义(χ^(2)=4.44,P=0.035)。两组治疗后血清血管内皮生长因子(VEGF)、糖类抗原125(CA125)水平均低于治疗前(均P<0.001),且治疗后研究组均低于对照组[VEGF:(223±15)pg/ml比(289±15)pg/ml,t=20.82,P<0.001;CA125:(23±6)ng/ml比(75±4)ng/ml,t=51.28,P<0.001];两组治疗后生命质量量表评分、Karnofsky评分均高于治疗前(均P<0.05),且治疗后研究组均高于对照组[生命质量量表评分:(63±6)分比(51±5)分,t=10.29,P<0.001;Karnofsky评分:(80.5±5.7)分比(78.8±3.7)分,t=1.70,P=0.041];两组治疗后T细胞亚群相关指标均高于治疗前(均P<0.001),且治疗后研究组均高于对照组[CD3^(+)细胞比例:(68±5)%比(65±5)%,t=2.52,P=0.014;CD4^(+)细胞比例:(42.5±1.7)%比(36.5±3.7)%,t=9.91,P<0.001;CD4^(+)/CD8^(+):1.78±0.54比1.46±0.27,t=3.56,P<0.001]。研究组和对照组不良反应总发生率差异无统计学意义[11.11%(5/45)比15.55%(7/45),χ^(2)=0.39,P=0.534]。随访6个月,研究组OS优于对照组(χ^(2)=3.86,P=0.044)。结论信迪利单抗联合紫杉类药物二线治疗晚期NSCLC有效,可
Objective To investigate the efficacy of sintilimab combined with paclitaxel and docetaxel in the treatment of advanced non-small cell lung cancer(NSCLC).Methods Prospective cohort study was performed.A total of 90 patients with advanced NSCLC receiving second-line treatment in Baotou Cancer Hospital from October 2019 to October 2022 were prospectively selected.All patients were divided into the study group(sintilimab combined with paclitaxel and docetaxel as second-line treatment,45 cases)and the control group(paclitaxel or docetaxel alone,45 cases)according to random number table method.The short-term efficacy,serum cytokine levels,quality of life and T-cell subsets of the two groups were compared.The survival of patients within 6 months was followed up.Kaplan-Meier method was used to analyze the overall survival(OS)of both groups,and log-rank test was used to make comparison among groups.Results There were 25 males(55.56%)in the study group with the age of(63±5)years and 28 males(62.22%)in the control group with the age of(65±6)years.There were no statistically significant differences in the gender,age,Eastern Cooperative Oncology Group scores,the body mass(all P>0.05).The total effective rate was 88.89%(40/45)in the study group and 71.11%(32/45)in the control group,and the difference was statistically significant(χ^(2)=4.44,P=0.035).The levels of serum vascular endothelial growth factor(VEGF)and carbohydrate antigen 125(CA125)of both groups after treatment were lower than those before treatment(all P<0.001);the levels of VEGF and CA125 in the study group after treatment were lower than those in the control group[VEGF:(223±15)pg/ml vs.(289±15)pg/ml,t=20.82,P<0.001;CA125:(23±6)ng/ml vs.(75±4)ng/ml,t=51.28,P<0.001].Quality of life scale score,Karnofsky score of both groups after treatment were higher than those before treatment(all P<0.05);quality of life scale score and Karnofsky score in the study group after treatment were higher than those in the control group[quality of life scale score:(63±6)scores
作者
蔚晓勇
李晓凤
史婉婷
杜家乐
Wei Xiaoyong;Li Xiaofeng;Shi Wanting;Du Jiale(Graduate School,Baotou Medical College,Baotou 014060,China;Department of Thoracic Oncology,Baotou Cancer Hospital,Baotou 014030,China)
出处
《肿瘤研究与临床》
CAS
2024年第1期6-10,共5页
Cancer Research and Clinic
基金
吴阶平医学基金会临床科研专项(320.6750.19094-37)。
关键词
癌
非小细胞肺
免疫检查点抑制剂
紫杉烷类
治疗结果
Carcinoma,non-small-cell lung
Immune checkpoint inhibitors
Taxoids
Treatment outcome
