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免疫检查点抑制剂在复发性、持续性、转移性宫颈鳞状细胞癌治疗中疗效及安全性

Study on the efficacy and safety of immune checkpoint inhibitors in the treatment of recurrent, persistent and metastatic cervical squamous cell carcinoma

投稿时间：2024-01-16 修订日期：2024-03-06

DOI：

中文关键词: 免疫检查点抑制剂子宫颈鳞状细胞癌疗效安全性

英文关键词:Immune checkpoint inhibitors cervical squamous cell carcinoma curative effect security

基金项目:

作者	单位	邮编
郑宝艳	天津石氏医院	300381
程敏^*	中国医学科学院肿瘤医院	100021
张楠	北京市朝阳区桓兴肿瘤医院

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中文摘要:

［目的］观察免疫检查点抑制剂（ICIs）在复发性、持续性、转移性宫颈鳞状细胞癌治疗中的疗效及安全性。［方法］回顾性分析2020年1月至2023年8月期间，在中国医学科学院肿瘤医院、北京市朝阳区桓兴肿瘤医院及天津石氏医院43例应用免疫检查点抑制剂治疗的复发性、持续性、转移性宫颈鳞状细胞癌患者，详细记录患者的疗效以及副反应情况。［结果］中位年龄58（26-73）岁，中位治疗4（1-21）周期，中位随访12（1-52）月，ORR：39.5%，DCR：79.1%，中位PFS13个月，中位OS32个月，常见不良反应为：白细胞减少(48.8%)，胃肠反应(32.6%)，血小板减少(18.6%)，瘙痒皮疹(16.3%)，肝功能不全（14.0%）。≥3级不良反应发生率58.1%（25/43），包括：白细胞减少，血小板减少，胃肠反应，瘙痒皮疹，甲减，甲亢，心肌炎，肺炎等。1例因不良反应终止治疗，1例并发阴道尿道瘘，1例因感染并发症死亡。［结论］免疫检查点抑制剂在复发性、持续性、转移性宫颈鳞状细胞癌治疗中展现出了令人振奋的疗效。然而，我们也需要高度关注其可能带来的严重不良反应。

英文摘要:

Objective : To observe the efficacy and safety of immune checkpoint inhibitors ( ICIs ) in the treatment of recurrent, persistent and metastatic cervical squamous cell carcinoma. Methods : A retrospective analysis of 43 patients with recurrent, persistent and metastatic cervical squamous cell carcinoma treated with immune checkpoint inhibitors in Cancer Hospital of Chinese Academy of Medical Sciences, Cancer Hospital of HuanxingbeijingChaoYang District and Tianjin Shixuenin General Hospital from January 2020 to August 2023. The efficacy and side effects of the patients were recorded in detail.Results: The median age was 58 ( 26-73 ) years, median treatment 4 ( 1-21 ) cycles, median follow-up 12 ( 1-52 ) months, ORR : 39.5 %, DCR : 79.1 %, median PFS13 months, median OS32 months, common adverse reactions : leukopenia ( 48.8 % ), gastrointestinal reaction ( 32.6 % ), thrombocytopenia ( 18.6 % ), itching rash ( 16.3 % ), liver dysfunction ( 14.0 % ). The incidence of grade ≥ 3 adverse reactions was 58.1 % ( 25 / 43 ), including leukopenia, thrombocytopenia, gastrointestinal reactions, itching rash, hypothyroidism, hyperthyroidism, myocarditis, pneumonia, etc. One case terminated treatment due to adverse reactions, 1 case complicated with vaginal urethral fistula, and 1 case died of infection complications. Conclusion: Immune checkpoint inhibitors have shown exciting efficacy in the treatment of recurrent, persistent, and metastatic cervical squamous cell carcinoma. However, we also need to pay close attention to its possible serious adverse reactions.

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