摘要
目的观察舒格利单抗联合EP同步化放疗治疗Ⅲ期不可手术切除非小细胞肺癌(non-small-cell carcinoma,NSCLC)的疗效。方法前瞻性研究,纳入Ⅲ期不可手术切除的NSCLC患者85例作为研究对象,根据随机数字表法分为对照组(42例)和观察组(43例)。对照组采用同步化放疗治疗,化疗方案为EP方案,放疗总剂量为60~66 Gy,1.8~2.0 Gy/d,30~33次。观察组在对照组同步化放疗基础上联合舒格利单抗治疗,以21 d为1个周期。2组均治疗3个周期后评估治疗效果。治疗前后检测患者肿瘤标志物水平[血清癌抗原125(CA125)、癌胚抗原(CEA)及细胞角蛋白19片段抗原21-1(Cyfra21-1)]、免疫指标[CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)],记录治疗期间不良反应发生情况。结果观察组临床治疗控制率高于对照组(P<0.05)。较治疗前,2组患者CA125、CEA、Cyfra21-1水平均降低,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)降低,且观察组CA125、CEA、Cyfra21-1水平低于对照组,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05)。组间不良反应发生率比较,差异无统计学意义(P>0.05)。结论舒格利单抗联合EP同步化放疗治疗Ⅲ期不可手术切除NSCLC,较单一EP同步放化疗方案整体疗效更好,能获得更理想的临床控制率,降低患者肿瘤标志物水平,并在一定程度上减轻化疗药物导致的免疫抑制,且不会增加不良反应的发生。
Objective To observe the efficacy of the combination of Shuglizumab and EP synchronous radiotherapy in the treatment of stageⅢunresectable non-small-cell carcinoma(NSCLC).Methods A prospective study was conducted on 85 patients with stageⅢunresectable NSCLC.According to the random number table method,the patients were divided into the control group(42 cases)and the observation group(43 cases).The control group received synchronous radiotherapy and chemotherapy,with an EP regimen and a total radiation dose of 60-66 Gy,1.8-2.0 Gy/d,30-33 times.On the basis of the control group,the observation group was treated with Shuglizumab.Before the implementation of chemotherapy and radiotherapy,both groups of patients were treated with intravenous injection of drugs to prevent vomiting,with 21 days as a cycle,and the treatment effect was evaluated after 3 cycles of treatment.The rest between chemotherapy cycles was 1 week,and the maximum total treatment time was not more than 7 weeks.The levels of tumor markers[serum cancer antigen 125(CA125),carcinoembryonic antigen(CEA)and cytokeratin 19 fragment antigen 21-1(Cyfra21-1)]and immune indexes[CD3^(+),CD4^(+),CD4^(+)/CD8^(+)]were detected before and after treatment,and the occurrence of adverse reactions during treatment was recorded.Results The clinical treatment control rate of the observation group was higher than that of the control group(P<0.05).Compared with before treatment,the levels of CA125,CEA,and Cyfra21-1 in both groups of patients decreased,while CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)decreased.The levels of CA125,CEA,and Cyfra21-1 in the observation group were lower than those in the control group,while CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)were higher than those in the control group(P<0.05).There was no statistical significant difference in the incidence of adverse reactions between groups(P>0.05).Conclusion The combination of Shuglimab and EP synchronous chemoradiotherapy for stageⅢunresectable NSCLC has better overall efficacy than the single EP synchronous chemoradiotherapy regimen.It can a-chieve a more ideal clinical control rate,reduce the level of tumor markers in patients,alleviate immune suppression caused by chemotherapy drugs to a certain extent,and does not increase the occurrence of adverse reactions.
作者
刘晓龙
史俊岩
LIU Xiaolong;SHI Junyan(General Hospital of Pingmei Shenma Group,Pingdingshan,467000)
出处
《实用癌症杂志》
2025年第5期812-816,共5页
The Practical Journal of Cancer
