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| 组织间插植放疗联合PD-1单抗对晚期非小细胞肺癌远期生存的影响及其预后因素分析卢俊,秦娟,邓佳秀,张加勇,刘建林,潘荣强南充市中心医院(北京安贞医院南充医院)/川北医学院第二临床医学院 肿瘤科,四川南充,637000 |
| Analysis of the long-term survival and prognostic factors of patients with advanced non-small cell lung cancer treated with interstitial brachytherapy combined with PD-1 monoclonal antibody |
| 投稿时间：2024-05-31 修订日期：2024-07-08 |
| DOI： |
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| 中文关键词: 组织间插植放疗 PD-1单抗 晚期非小细胞肺癌 远期生存 预后 |
| 英文关键词:interstitial brachytherapy pd-1 monoclonal antibody advanced non-small cell lung cancer long term survival prognosis |
| 基金项目:四川省抗癌协会临床科研(齐鲁)基层项目(编号XH2023-126) |
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| 中文摘要: |
| 目的 探讨组织间插植放疗联合PD-1单抗对晚期非小细胞肺癌(Non-small cell lung cancer,NSCLC)患者远期生存的影响及其预后因素分析。方法 本研究收集于2020年1月至2023年12月在我院诊治的晚期非小细胞肺癌患者70例,既往接受三线以上治疗方案后出现疾病进展,患者均接受组织间插植放疗联合PD-1单抗的治疗方案,收集患者的一般资料以及血液相关指标,评估患者的近期疗效以及远期预后情况,采用Log-Rank检验患者的一般资料并通过Cox多因素分析影响NSCLC患者总生存期(Overall survival,OS)的因素。结果 70例患者均接受了组织间插植放疗联合PD-1单抗方案治疗,患者治疗周期4.62±1.12个,其中完全缓解(Complete response,CR)患者0例,部分缓解(Partial response,PR)患者12例占比17.14%,疾病稳定(Stable disease,SD)患者45例占比64.29%,疾病进展(Progressed disease,PD)患者13例占比18.57%,ORR为17.14%,总有效率为81.43%。患者PFS为4个月,OS为14个月。在治疗过程中未观察到致命性不良反应,患者对治疗的耐受性良好且3~4级严重不良反应患者5例占比7.14%。Log-Rank检验结果显示,患者的ECOG评分在0~1分,C反应蛋白≤10mg/mL、NLR≤5以及PD-L1表达阳性在治疗中有更长的中位总生存,Cox多因素分析显示ECOG评分、C反应蛋白、NLR以及PD-L1表达量均是NSCLC患者OS的影响因素(P<0.05)。结论 组织间插植放疗联合PD-1单抗的综合治疗为晚期NSCLC患者提供了一种有效的治疗选择,ECOG评分、CRP、NLR和PD-L1表达情况都是评估晚期NSCLC患者在接受组织间插植放疗联合PD-1单抗治疗后临床预后的重要指标。 |
| 英文摘要: |
| Objective Exploring the effect of interstitial brachytherapy combined with PD-1 monoclonal antibody on advanced non-small cell lung cancer, Analysis of the impact and prognostic factors on long-term survival of NSCLC patients. Methods This study collected 70 patients with advanced non-small cell lung cancer who were treated in our hospital from January 2020 to December 2023. After receiving a third line or higher treatment regimen, the disease progressed and all patients received a treatment regimen of interstitial brachytherapy combined with PD-1 monoclonal antibody. The general information and blood related indicators of the patients were collected to evaluate their short-term efficacy and long-term prognosis. Log Rank test was used to test the general information of the patients, and Cox multivariate analysis was used to analyze the factors affecting the overall survival (OS) of NSCLC patients. Results 70 patients all received interstitial brachytherapy combined with PD-1 monoclonal antibody regimen, with a treatment period of 4.62 ± 1.12, and complete response, CR patients with 0 cases, partial response, 12 PR patients account for 17.14%, and the disease is stable, 45 patients with SD accounted for 64.29%, and the disease progressed, 13 patients with PD accounted for 18.57%, The ORR is 17.14%, and the total effective rate is 81.43%. The PFS of the patient is 4 months, and the OS is 14 months. No fatal adverse reactions were observed during the treatment process, and the patient had good tolerance to the treatment. There were 5 patients with severe adverse reactions of grades 3-4, accounting for 7.14%. The Log Rank test results show that the patient"s ECOG score ranges from 0 to 1, C-reactive protein ≤ 10mg/mL NLR ≤ 5 and PD-L1 positive expression have a longer median overall survival in treatment, Cox multivariate analysis showed that ECOG score C-reactive protein The expression levels of NLR and PD-L1 are both influencing factors for OS in NSCLC patients (P<0.05). Conclusion The comprehensive treatment of interstitial brachytherapy combined with PD-1 monoclonal antibody provides an effective treatment option for advanced NSCLC patients, ECOG score The expression levels of CRP, NLR, and PD-L1 are important indicators for evaluating the clinical prognosis of advanced NSCLC patients after receiving interstitial brachytherapy combined with PD-1 monoclonal antibody treatment. |
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