摘要
目的评估替吉奥胶囊联合调强放射治疗(IMRT)后序贯信迪利单抗免疫治疗对局部晚期食管癌老年患者的安全性及有效性。方法选择2020年12月至2023年12月在南京医科大学附属无锡人民医院及南京医科大学附属苏州医院治疗的96例局部晚期食管癌老年患者为研究对象。通过随机数字表法分为对照组(n=48)和联合组(n=48)。对照组接受同步放化疗,联合组在对照组基础上序贯信迪利单抗免疫治疗。分析两组患者的临床疗效,治疗前后的肿瘤标志物、免疫水平、生活质量以及放射性食管炎、免疫性肺炎及毒副作用发生情况。结果治疗后3个月,联合组的ORR、DCR均高于对照组(P<0.05)。联合组患者治疗后CEA、CA199、AFP、CYFRA21-1水平均低于对照组,CD4^(+)、CD16^(+)CD56^(+)NK水平高于对照组(P<0.05)。联合组患者治疗后3个月,癌症共性、食管癌特异性评分均低于对照组(P<0.05)。联合组的放射性食管炎、免疫性肺炎及相关毒副作用发生情况与对照组比较差异无统计学意义(P>0.05)。结论同步放化疗序贯信迪利单抗免疫治疗可显著提高局部晚期食管癌老年患者的临床疗效,且不增加显著的治疗相关毒性,有助于提升患者的免疫功能,值得临床进一步推广应用。
Objective To investigate the safety and efficacy of Tigio capsules combined with intensitymodulated radiation therapy(IMRT),followed by sequential sintilimab immunotherapy in elderly patients with locally advanced esophageal cancer.Methods From December 2020 to December 2023,96 elderly patients with locally advanced esophageal cancer treated in Wuxi People′s Hospital and Suzhou Hospital affiliated to Nanjing Medical University were selected.Using a random number table method,patients were divided into reference group(n=48)and combination group(n=48).The reference group received concurrent chemoradiotherapy,while the combination group received sequential sintilimab immunotherapy combined with concurrent chemoradiotherapy.The clinical efficacy,changes in tumor markers(CEA,CA199,AFP,CYFRA21-1),immune levels(CD4+,CD8+,CD16+CD56+NK),quality of life(QLICP-ES),and the incidence of radiation esophagitis,and immune pneumonitis,and other toxic effects were analyzed.Results After three months of treatment,the combination group showed higher ORR and DCR than the reference group(P<0.05).Levels of CEA,CA199,AFP,and CYFRA21-1 were lower in the combination group,whereas CD4+,CD16+CD56+NK levels were higher(P<0.05).Additionally,common and esophageal cancer-specific scores of the Quality of Life Instruments for Cancer Patients-Esophagus Cancer(QLICP-ES)were lower in the combination group(P<0.05).The incidence of radiation esophagitis,and immune pneumonitis,and related toxic effects showed no significant difference between the two groups(P>0.05).Conclusion Concurrent chemoradiotherapy followed by sequential sintilimab immunotherapy significantly improves clinical efficacy in elderly patients with locally advanced esophageal cancer and does not increasesignificant treatment-related toxicity.This approach enhances patients′immune function and is worthy of further clinical application.
作者
王豪
陆筱祎
王文杰
WANG Hao;LU Xiaoyi;WANG Wenjie(Department of Radiation Oncology,the Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi 214000,Jiangsu,China;不详)
出处
《实用医学杂志》
北大核心
2025年第3期365-370,共6页
The Journal of Practical Medicine
基金
江苏省自然科学基金面上项目(编号:BK20221373)。
关键词
局部晚期食管癌
老年患者
替吉奥胶囊
调强放射治疗
信迪利单抗
locally advanced esophageal cancer
elderly patients
Tegafur capsule
intensitymodulated radiation therapy
sintilimab
作者简介
通信作者:王文杰,E-mail:suda_wangwenjie@163.com。
