摘要
目的探讨免疫治疗联合含铂双药治疗肺腺癌疗效及对患者短期生存的影响.方法选取114例肺腺癌患者,采用单双球法随机分为对照组和试验组,每组57例,对照组给予含铂双药方案(培美曲塞^(+)顺铂)治疗,试验组给予免疫治疗(PD-1抑制剂)联合含铂双药方案治疗.治疗4疗程后,分析两组患者临床疗效,比较治疗前和治疗4疗程后两组患者肿瘤标志物(癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、糖类抗原125(CA-125))水平、免疫功能(T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)))水平.随访6个月,记录两组患者总生存率及毒副反应(消化道反应、血液毒性、骨髓抑制)情况.结果治疗4疗程后,试验组总缓解率显著高于对照组(P<0.05);两组患者CEA、CYFRA21-1、CA-125水平均较治疗前降低,试验组CEA、CYFRA21-1、CA-125水平低于对照组(均P<0.05);CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前降低,但试验组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组(均P<0.05);试验组总生存率高于对照组(P<0.05);两组患者毒副反应发生率比较差异无统计学意义(P>0.05).结论免疫治疗联合含铂双药方案可提高肺腺癌疗效,改善患者肿瘤标志物水平、免疫抑制及毒副反应,提高患者短期生存率.
Objective To explore the efficacy of immunotherapy combined with platinum-containing dual drugs in treating lung adenocarcinoma and its influence on short-term survival of patients.Method 114 patients with lung adenocarcinoma were selected and randomly divided into control group and observation group by singledouble ball method,with 57 cases in each group.The control group was treated with platinum-containing dualdrug regimen(pemetrexed^(+)cisplatin),and the observation group was given immunotherapy(PD-1 inhibitor)combined with platinum-containing dual-drug regimen.After 4 courses of treatment,the clinical efficacy of the two groups was analyzed.The levels of tumor markers(carcino-embryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1),carbohydrate antigen 125(CA-125))and immune function(T lymphocyte subsets(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)))were compared between the two groups before treatment and after 21 days of treatment.After 6 months of follow-up,the overall survival rate and toxic and side effects(digestive tract reaction,hematotoxicity,myelosuppression)of the two groups were recorded.Results The total remission rate after 4 courses treatment in observation group was significantly higher comparing to control group(P<0.05).The levels of CEA,CYFRA21-1 and CA-125 in both groups reduced comparing with those before treatment,and the levels of CEA,CYFRA21-1 and CA-125 in observation group were lower than those in control group(all P<0.05).The levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were declined comparing to before treatment,but the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in observation group were higher that those in control group(all P<0.05).The overall survival rate in observation group was higher than that of control group(P<0.05).There were no significant differences in the incidence rates of toxic and side effects between the two groups(P>0.05).Conclusion Immunotherapy combined with platinum-containing dual-drug regimen can enhance the efficacy of lung adenocarcinoma,improve the levels of tumor markers,immuno-suppression and toxic and side effects,and promote the short-term survival rate.
作者
吴西
张家艳
殷俊
杨春茂
WU Xi;ZHANG Jiayan;YIN Jun;YANG Chunmao(The Third People’s Hospital of Chengdu,Chengdu 610004,China)
出处
《北华大学学报（自然科学版）》
CAS
2023年第5期617-621,共5页
Journal of Beihua University（Natural Science）
基金
四川省医学会(青年创新)科研课题(Q20009)。
关键词
肺腺癌
免疫治疗
含铂双药
短期生存
毒副反应
lung adenocarcinoma
immunotherapy
platinum-containing dual drugs
short-term survival
toxic and side effects
作者简介
吴西(1989-),女,医师,主要从事慢性阻塞性肺疾病临床研究,E-mail:wuxi19890427@163.com.
