| 卢 俊,秦 娟,邓佳秀,等.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[J].肿瘤学杂志,2024,30(9):738-744. |
| 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 |
| Efficacy of Interstitial Brachytherapy Combined with PD-1 Monoclonal Antibody in Treatment of Advanced Non-Small Cell Lung Cancer and Related Prognostic Factors of Patients |
| 投稿时间：2024-05-31 |
| DOI：10.11735/j.issn.1671-170X.2024.09.B005 |
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| 中文关键词: 非小细胞肺癌 组织间插植放疗 PD-1单抗 生存期 预后 |
| 英文关键词:non-small cell lung cancer interstitial brachytherapy PD-1 monoclonal antibody survival prognosis |
| 基金项目:四川省抗癌协会临床科研（齐鲁）基层项目（XH2023-126） |
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| 摘要点击次数: 120 |
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| 中文摘要: |
| 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影响因素。［方法］ 回顾性分析2020年1月至2023年12月诊治的晚期NSCLC患者70例，既往接受一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，评估患者的近期疗效以及远期预后。采用Cox多因素分析影响NSCLC患者总生存期（overall survival，OS）的影响因素。［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，患者平均治疗周期为（4.62±1.12）个，无完全缓解，部分缓解12例（17.14%），疾病稳定45例（64.29%），疾病进展13例（18.57%），客观缓解率为17.14%，总有效率为81.43%。患者中位无进展生存期为4个月，中位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，3~4级严重不良反应患者5例，占比7.14%。Log-rank检验结果为患者ECOG评分0~1分、C反应蛋白≤10 mg/mL、NLR≤5以及PD-L1表达阳性患者有更长OS。Cox多因素分析显示ECOG评分、C反应蛋白、中性粒细胞与淋巴细胞比值以及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、C反应蛋白、中性粒细胞与淋巴细胞比值和PD-L1表达均是评估晚期NSCLC患者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: |
| Abstract：［Objective］ To investigate the efficacy of interstitial brachytherapy combined with PD-1 monoclonal antibody in treatment of advanced non-small cell lung cancer(NSCLC) and to analyze the influencing factors of patient prognosis. ［Methods］ Seventy patients with advanced NSCLC， who received a first line or higher treatment regimen and the disease progressed， were from January 2020 to December 2023. All patients underwent a treatment regimen of interstitial brachytherapy combined with PD-1 monoclonal antibody. Patients were followed up and the short-term efficacy and long-term outcomes were evaluated. The factors affecting the overall survival (OS) of patients were analyzed with Cox multivariate regression. ［Results］ Patients received a median treatment cycle of 4.62±1.12， there was no case of complete response， 12 cases(17.14%) of partial response， 45 cases (64.29%) of stable disease， and 13 cases (18.57%) of progressive disease. The objective response rate was 17.14%， and the total effective rate was 81.43%. The median progression-free survival of the patient was 4 months， and the median OS was 14 months. Patient had good tolerance to the treatment， and no fatal adverse reaction was observed. There were 5 patients with severe adverse reactions of grades 3~4， accounting for 7.14%. The Log-rank test results show that the patients with ECOG score 0~1， C-reactive protein (CRP) ≤10 mg/mL， neutrophil-to-lymphocyte ratio (NLR) ≤5 and positive PD-L1 had a longer OS. Cox multivariate analysis showed that ECOG score， CRP， NLR and positive PD-L1 were independent influencing factors for OS in NSCLC patients (P<0.05). ［Conclusion］ The interstitial brachytherapy combined with PD-1 monoclonal antibody provides an effective treatment option for advanced NSCLC patients. ECOG score， CRP NLR， and positive PD-L1 are predictors for clinical outcomes of patients receiving the combination regimen. |
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