摘要
目的观察卡瑞利珠单抗联合白蛋白紫杉醇+顺铂化疗用于局部晚期食管癌术前新辅助治疗的临床效果。方法回顾性分析北部战区总医院2021年3—12月收治的43例接受术前新辅助治疗及食管癌根治手术的局部晚期食管癌患者的临床资料。根据治疗方法不同,将患者分入A组(n=23)与B组(n=20)。A组术前应用白蛋白紫杉醇+顺铂化疗;B组术前应用卡瑞利珠单抗联合白蛋白紫杉醇+顺铂化疗。比较两组患者的围术期指标,新辅助治疗后近期治疗效果,化疗不良反应发生率,术后T、N降级情况及病理学完全缓解率。结果B组R0切除率高于A组,手术时间短于A组,术中出血量少于A组,差异有统计学意义(P<0.05)。A组和B组术后住院时间比较,差异无统计学意义(P>0.05)。B组完全缓解率、疾病缓解率均高于A组,疾病稳定率低于A组,差异有统计学意义(P<0.05)。B组T降级、N降级比例均高于A组,差异有统计学意义(P<0.05)。B组病理学完全缓解率高于A组,差异有统计学意义(P<0.05)。A组和B组化疗不良反应发生率比较,差异无统计学意义(P>0.05)。结论卡瑞利珠单抗联合白蛋白紫杉醇+顺铂化疗用于局部晚期食管癌术前新辅助治疗可显著改善手术治疗效果,提高病理学完全缓解率。
Objective To investigate the efficacy of carrelizumab combined with albumin-bound paclitaxel and cisplatin in preoperative neoadjuvant therapy for locally advanced esophageal cancer.Methods A retrospective analysis was performed on the clinical data of 43 patients with locally advanced esophageal cancer who received preoperative neoadjuvant therapy and radical resection of esophageal cancer in General Hospital of Northern Theater Command from March to December 2021.Patients were divided into group A(n=23)and group B(n=20)according to different treatment methods.Group A received albumin-bound paclitaxel+cisplatin chemotherapy before surgery.Group B received preoperative chemotherapy with carrelizumab combined with albumin-bound paclitaxel and cisplatin.The perioperative indicators,short-term treatment effect after neoadjuvant therapy,incidence of adverse chemotherapy reactions,postoperative T and N degradation and pathological complete remission rate were compared between the two groups.Results The R0 resection rate of group B was higher than that of group A,the operation time was shorter than that of group A,and the intraoperative blood loss was less than that of group A,the differences were statistically significant(P<0.05).There was no significant difference in postoperative hospitalization time between group A and group B(P>0.05).The complete remission rate and disease remission rate in group B were higher than those in group A,and the disease stability rate was lower than those in group A,with statistical significance(P<0.05).The proportion of T and N degradation in group B was higher than that in group A,and the difference was statistically significant(P<0.05).The pathological complete remission rate of group B was higher than that of group A,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of chemotherapy adverse reactions between group A and group B(P>0.05).Conclusion Carrelizumab combined with albumin-bound paclitaxel+cisplatin chemotherapy for preoperative neoadjuvant therapy of locally advanced esophageal cancer can significantly improve the efficacy of surgical treatment and improve the pathological complete response rate.
作者
王希龙
修家伟
李旭
孟浩
刘博
徐惟
丁仁泉
李博
王通
刘星池
滕洪
许世广
WANG Xi-long;XIU Jia-wei;LI Xu;MENG Hao;LIU Bo;XU Wei;DING Ren-quan;LI Bo;WANG Tong;LIU Xing-chi;TENG Hong;XU Shi-guang(Department of Thoracic Surgery,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《临床军医杂志》
CAS
2022年第8期806-809,813,共5页
Clinical Journal of Medical Officers
基金
辽宁省博士启动基金(2021-BS-033)
关键词
免疫治疗
食管癌
术前新辅助治疗
卡瑞利珠单抗
白蛋白紫杉醇
顺铂
Immunotherapy
Esophageal cancer
Preoperative neoadjuvant therapy
Carrellizumab
Albumin-bound paclitaxel
Cisplatin
作者简介
第一作者:王希龙(1986-),男,山东滨州人,主治医师,硕士;通信作者:许世广,E-mail:oldmonitor73@163.com
