摘要
目的探讨替雷利珠单抗联合贝伐珠单抗及含铂化疗在晚期非鳞状非小细胞肺癌(NSCLC)患者中的临床疗效和安全性。方法选取2020年6月至2024年6月在焦作煤业(集团)有限责任公司中央医院确诊的90例ⅢB~Ⅳ期非鳞状NSCLC患者,根据治疗方案分为两组。对照组(45例)给予贝伐珠单抗联合化疗(培美曲塞、卡铂),观察组(45例)加用替雷利珠单抗,共治疗4个周期(1周期21天)。比较两组疗效和治疗期间不良反应差异,以及治疗前后T淋巴细胞亚群、癌因性疼痛与疲乏程度变化和差异。结果观察组患者的客观缓解率(ORR)、疾病控制率(DCR)为68.89%和95.56%,分别高于对照组的44.44%和80.00%,差异有统计学意义(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前降低,CD8^(+)水平均较治疗前升高,但观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。治疗后,两组视觉模拟评分(VAS)、简易疲乏量表中国版(BFI-C)评分均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者皮疹、胃肠道反应、骨髓抑制、白细胞减少、肝肾功能损伤发生率比较,差异无统计学意义(P>0.05)。结论替雷利珠单抗联合贝伐珠单抗及化疗可显著提高晚期非鳞状NSCLC患者的肿瘤控制率,有助于减轻化疗引起的免疫功能损伤及改善癌症相关疼痛与疲乏,且安全性良好。
Objective To investigate the clinical efficacy and safety of tislelizumab combined with bevacizumab and platinum-based chemotherapy in patients with advanced non-squamous non–small cell lung cancer(NSCLC).Methods Ninety patients with stage IIIB–IV non-squamous NSCLC who were diagnosed at the Central Hospital of Jiaozuo Coal Industry(Group)Co..Ltd.between June 2020 and June 2024 were enrolled.According to the treatment regimen.patients were divided into two groups.The control group(n=45)received bevacizumab plus chemotherapy(pemetrexed and carboplatin).and the observation group(n=45)received additional tislelizumab.Both groups were treated for four cycles(21 days per cycle).Treatment efficacy and adverse reactions during therapy were compared between the two groups.Changes and between-group differences in T-lymphocyte subsets.cancer-related pain.and fatigue before and after treatment were also evaluated.Results The objective response rate(ORR)and disease control rate(DCR)in the observation group were 68.89%and 95.56%.respectively.which were significantly higher than those in the control group(44.44%and 80.00%.respectively)(P<0.05).After treatment.levels of CD3^(+).CD4^(+).and CD4^(+)/CD8^(+)decreased and the CD8^(+)level increased in both groups compared with baseline;however.the observation group had higher levels of CD3^(+).CD4^(+).and CD4^(+)/CD8^(+)and a lower CD8^(+)level than the control group.with statistically significant differences(P<0.05).After treatment.visual analogue scale(VAS)scores and Chinese version of the Brief Fatigue Inventory(BFI-C)scores decreased in both groups compared with baseline.and both scores were lower in the observation group than in the control group(P<0.05).During treatment.there were no statistically significant differences between the two groups in the incidences of rash.gastrointestinal reactions.myelosuppression.leukopenia.or hepatic and renal dysfunction(P>0.05).Conclusion Tislelizumab combined with bevacizumab and chemotherapy can significantly improve tumor control in patients with advanced non-squamous NSCLC.alleviate chemotherapy-induced immunosuppression as well as cancer-related pain and fatigue.and demonstrates a favorable safety profile.
作者
薛苗苗
牛飞
XUE Miaomiao;NIU Fei(Oncology Ward I,Department of Medical Oncology,Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.,Jiaozuo Henan 454000,China;Cancer Center(Medical Ward),Jiaozuo People’s Hospital,Jiaozuo Henan 454000,China)
出处
《临床研究》
2026年第2期42-45,共4页
Clinical Research
