摘要
目的:探讨帕博利珠单抗辅助依托泊苷及顺铂(Etoposide and cisplatin,EP)化疗治疗对小细胞肺癌(Small cell lung cancer,SCLC)患者疾病控制率及生存率的影响。方法:选取我院2020年3月至2023年4月收治的SCLC患者94例,根信封法将其分为47例EP组(静脉滴注顺铂70 mg·m-2^(+)依托泊苷100 mg·m-2)、47例联合组(基于EP组方法增加静脉注射帕博利珠单抗200 mg)。两组持续治疗4个周期。比较两组临床疗效,于治疗前、治疗4个周期后采用化学发光免疫法检测胃泌素释放肽前体(Pro-gastrin-releasing peptide,ProGRP)、神经元特异性烯醇化酶(Neuron-specific enolase,NSE)、癌胚抗原(Carcinoembryonic antigen,CEA)水平,采用酶联免疫吸附法检测基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)水平,采用流式细胞仪检测CD3^(+)、CD4^(+)水平并计算CD4^(+)/CD8^(^(+)),记录比较两组毒副反应发生率及生存率(半年、1年)。结果:联合组疾病控制率及半年、1年生存率高于EP组(P<0.05)。两组Ⅰ-Ⅳ级毒副反应发生率比较无明显差异(P>0.05)。与EP组比较,联合组治疗后的ProGRP、NSE、CEA、MMP-9、TNF-α较低(P<0.05)。两组治疗后的CD3^(+)、CD4^(+)/CD8^(+)、CD4^(+)均下降,但联合组高于EP组(P<0.05)。结论:帕博利珠单抗辅助EP化疗可提高SCLC患者疗效,降低肿瘤标志物水平,改善免疫功能及因子水平,提高远期生存率。
Objective:To investigate the effect of adjuvant Etoposide and cisplatin(EP)chemotherapy with pembrolizumab on disease control rate and survival rate in patients with Small cell lung cancer(SCLC).Methods:Ninety-four patients with SCLC admitted to our hospital from March 2020 to April 2023 were selected and randomly divided into 47 patients in the EP group(70 mg·m-2 cisplatin^(+)100 mg·m-2 etoposide by intravenous infusion)and 47 cases in the combined group(based on the EP group method with the addition 200 mg of pembrolizumab by intravenous).according to the random envelope method.Both groups underwent treatment for four consecutive cycles.The clinical efficacy of the two groups was compared.Before treatment and after four cycles of treatment,the levels of Pro-gastrin-releasing peptide(ProGRP),Neuron-specific enolase(NSE),and Carcinoembryonic antigen(CEA)were detected by chemiluminescence immunoassay.The levels of Matrix metalloproteinase-9(MMP-9)and Tumor necrosis factor-α(TNF-α)were detected by enzyme-linked immunosorbent assay.The levels of CD3^(+)and CD4^(+)were detected by flow cytometry,and the CD4^(+)/CD8^(+)ratio was calculated.The incidence of toxic side effects and survival rate(half a year and one year)were recorded and compared between the two groups.Results:The disease control rate and survival rate of the half-year and one-year in the combined group were higher than those in the EP group(P<0.05).There was no significant difference in the incidence of grade I-IV toxic and side effects between the two groups(P>0.05).Compared with the EP group,the levels of ProGRP,NSE,CEA,MMP-9,and TNF-αwere lower in the combined group after treatment(P<0.05).After treatment,CD3^(+),CD4^(+)/CD8^(+),and CD4^(+)in both groups decreased,but the combined group was higher than the EP group(P<0.05).Conclusion:Adjuvant EP chemotherapy with pembrolizumab can improve the efficacy of SCLC patients,reduce tumor marker levels,improve immune function and factor levels,and increase long-term survival rate.
作者
刘璐
Liu Lu(Department of Oncology,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan,China)
