| 蔡碧玉,陆 怡,徐 超.免疫检查点抑制剂联合血管生成抑制剂治疗MSS型转移性结直肠癌的疗效与营养状态的相关性[J].肿瘤学杂志,2022,28(2):105-110. |
| 免疫检查点抑制剂联合血管生成抑制剂治疗MSS型转移性结直肠癌的疗效与营养状态的相关性 |
| Immune Checkpoint Inhibitor Combined with Angiogenesis Inhibitor in the Treatment of Microsatellite Stable Metastatic Colorectal Cancer |
| 投稿时间：2021-12-30 |
| DOI：10.11735/j.issn.1671-170X.2022.02.B005 |
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| 中文关键词: 结直肠癌 营养状态 免疫检查点抑制剂 血管生成抑制剂 疗效评价 |
| 英文关键词:colorectal cancer nutritional status immune checkpoint inhibitor angiogenesis inhibitor efficacy evaluation |
| 基金项目:浙江省中医药科技计划项目（2020ZA018，2022ZA024） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨营养状态与免疫检查点抑制剂(immune checkpoint inhibitor，ICI)联合血管生成抑制剂治疗微卫星稳定性（microsatellite stability，MSS）转移性结直肠癌（metastatic colorectal cancer，CRC）的疗效相关性。［方法］ 收集经一、二线标准治疗后，三线使用ICI联合血管生成抑制剂治疗的MSS型mCRC患者15例，记录患者临床资料及营养状态，客观描述不同营养状态下肿瘤指标和营养指标的变化情况，以客观缓解率（objective response rate，ORR）、疾病控制率（disease control rate，DCR）、无进展生存期（progress-free survival，PFS）为研究指标，通过COX回归分析疗效与营养状态的关系。 ［结果］ 对15例三线治疗患者中位随访3个月的数据显示，ORR为13%，DCR为53%，PFS为4.05个月（1.10个月~11.40个月）。基于描述性统计分析，PG-SGA ≥9分组患者的肿瘤指标上升幅度总体较PG-SGA 2~3分组患者偏高；PG-SGA 2~3分组患者的视黄醇结合蛋白较PG-SGA≥9分组患者的偏高，观察终点的视黄醇结合蛋白较PG-SGA 4~8分组患者的偏高，差异均有统计学意义（P＜0.05）；基于PFS指标，PG-SGA评分2～3分患者优于评分4～8分患者，评分4~8分患者优于评分≥9分患者，差异有统计学意义（P＜0.05）。PG-SGA 4~8分组患者相比较于PG-SGA 2~3分组患者和PG-SGA≥9分组患者对PFS的影响更大（HR=0.020，95%CI为0.001~0.549）。［结论］ 免疫检查点抑制剂联合血管生成抑制剂治疗MSS型转移性结直肠癌的疗效与营养状态密切相关，良好的营养状态可提高其治疗疗效，改善预后。 |
| 英文摘要: |
| Abstract： ［Objective］ To investigate the correlation between nutritional status and immune checkpoint inhibitor(ICI) combined with angiogenesis inhibitor in the treatment of microsatellite stable(MSS) metastatic colorectal cancer(mCRC). ［Methods］ Fifteen patients with MSS type mCRC treated with ICI combined with angiogenesis inhibitor after the first and second line of standard treatment were enrolled. Clinical data and nutritional status were collected for retrospective study. The objective response rate(ORR)， disease control rate(DCR) and progress-free survival(PFS) were calculated and the relationship between curative effect and nutritional status was analyzed with Cox regression. ［Results］ The 3-month follow-up data of 15 patients showed that ORR was 13%， DCR was 53%， and PFS was 4.05 months(1.10~11.40 months). Based on descriptive statistical analysis， the increase of tumor indicators in PG-SGA ≥9 group was generally higher than that in PG-SGA 2~3 group. The retinol binding protein in PG-SGA 2~3 group was higher than that in PG-SGA≥9 group， and the retinol binding protein in the observation end point was higher than that in PG-SGA 4~8 group(P<0.05). The PFS indicators in patients with PG-SGA 2~3 were better than those with PG-SGA 4~8， and the PFS indicators in patients with PG-SGA 4~8 were better than those with PG-SGA≥9(P<0.05). Patients in the PG-SGA 4~8 group had a greater impact on survival than those in the PG-SGA 2~3 group and those in the PG-SGA≥9 group(HR=0.020， 95%CI：0.001~0.549). ［Conclusion］ The therapeutic effect of MSS type mCRC treated with ICI combined with angiogenesis inhibitor is closely related to nutritional status， good nutritional status can improve the therapeutic effect and prognosis. |
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