摘要
目的 本研究探索局部晚期食管癌患者术前应用新辅助化疗联合卡瑞利珠单抗的治疗效果及对预后的影响。方法 回顾性分析2020年1月至2024年1月濮阳市人民医院接受手术治疗的60例局部晚期食管癌患者的临床资料。根据患者的术前新辅助治疗方式分为观察组(术前卡瑞利珠单抗联合新辅助化疗) 35例及对照组(术前仅接受新辅助化疗) 25例。比较两组的治疗效果、免疫功能、不良反应及术后并发症。结果 观察组患者的p CR、DCR和ORR均明显高于对照组(P<0.05);两组患者的R0切除、R1切除及手术治疗方式比较则差异无统计学意义(P>0.05);治疗前,两组患者CD3^(+)和CD4^(+)/CD8^(+)比较差异无统计学意义(P>0.05);组内比较,治疗后两组患者的CD3^(+)和CD4^(+)/CD8^(+)均较治疗前升高,且观察组升高得更为明显(P<0.05);观察组的不良反应事件发生率略高于对照组,且观察组总并发症的发生率略高于对照组;两组间比较,除了皮疹和免疫性肺炎发生率差异具有统计学意义(P<0.05),其他不良反应发生率均无统计学差异(P>0.05)。结论 局部晚期食管癌患者行术前新辅助化疗联合卡瑞利珠单抗治疗具有一定的安全性,且能在不增加术后并发症发生率的同时,增强患者的免疫功能和治愈率,值得临床推广应用。
Objective This study aims to explore the therapeutic effect of preoperative neoadjuvant chemotherapy combined with Carolizumab on locally advanced esophageal cancer patients and its impact on prognosis.Methods A retrospective analysis was conducted on the clinical data of 60 patients with locally advanced esophageal cancer who underwent surgical treatment in Puyang City People′s Hospital from January 2020 to January 2024.According to the preoperative neoadjuvant treatment method of the patients,they were divided into immunotherapy group(preoperative combination of Carolizumab and neoadjuvant chemotherapy)of 35 cases,and control group(preoperative only receiving neoadjuvant chemotherapy)of 25 cases.Comparison of treatment outcomes,immune function,adverse effects and postoperative complications between the two groups.Results The results showed that the pCR、DCR and ORR of the immunotherapy group were significantly higher than those of the control group(P<0.05);there were no significant difference between the two groups in the operation time of R0 resection,R1 resection and surgical treatment(P>0.05);Before treatment,there was no statistically significant difference in CD3^(+)and CD4^(+)/CD8^(+)between the two groups of patients(P>0.05);Compared within the group,after treatment,the levels of CD3^(+)and CD4^(+)/CD 8^(+)in both groups of patients increased compared to before treatment,and the increase was more significant in the immunotherapy group(P<0.05);In the cohort undergoing immunotherapy,the rate of adverse events was marginally elevated in comparison to the control group.Similarly,the prevalence of overall complications was modestly increased within the immunotherapy cohort.Yet,when statistical analysis was applied,these variations did not reach a level of significance that would distinguish the two groups distinctly(P>0.05).Conclusion In the context of managing locally advanced esophageal carcinoma,the integration of preoperative neoadjuvant chemotherapy with the monoclonal antibody karelizumab demonstrates a favorable safety profile.This therapeutic approach not only enhances the immune response and the overall survival rate among patients but also does not elevate the risk of postoperative adverse events.Consequently,this regimen merits consideration for broader clinical implementation.
作者
王辉
于海明
张宇
WANG Hui;YU Haiming;ZHANG Yu(Department of Thoracic Surgery,Puyang People′s Hospital,Puyang,China,457000)
出处
《食管疾病》
2025年第3期205-210,共6页
Journal of Esophageal Diseases
关键词
局部晚期食管癌
免疫治疗
新辅助化疗
免疫功能
并发症
locally advanced esophageal cancer
immunotherapy
neoadjuvant chemotherapy
immune function
complications
