Wang Yifei, Fei Jiandong, Zheng Yanan, Li Ping, Ren Xiaodong, An Yongzhu
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000 Hebei, China.
Central Laboratory, The First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000 Hebei, China.
J Oncol. 2022 Sep 16;2022:8675587. doi: 10.1155/2022/8675587. eCollection 2022.
To analyze the efficacy of combining sintilimab with neoadjuvant chemotherapy in treating middle and advanced rectal cancer based on big data.
According to the inclusion and exclusion criteria, 43 patients with middle and advanced rectal cancer, who were treated with sintilimab and neoadjuvant chemotherapy in General Surgery of the hospitals of Zhangjiakou city from January 2020 to January 2022, were selected for the retrospective study. The patients' short-term efficacy was scientifically evaluated, and the factors affecting efficacy and the correlation were analyzed.
Among the 43 enrolled patients, 30 of them had regional lymphatic metastasis but none had distant metastasis; most patients were at Broders II and TNM III, and all of them had adenocarcinoma; the total response rate was 69.77% (30 cases), with no grade IV and V adverse reactions; the patients were divided into the effective group and the ineffective group after treatment based on the evaluation results of short-term efficacy, and analysis of the relevant factors exposed in both groups revealed significant differences in age, tumor size, CEA, NLR value, PLR value, TNM stage, and presence of combined lymphatic metastasis between the two groups ( < 0.05); univariate analysis showed that tumor size, CEA, TNM stage, and combined lymphatic metastasis were the independent risk factors affecting the efficacy in patients with middle to advanced rectal cancer ( < 0.05); and through the Spearman correlation analysis of the above independent risk factors, it was further confirmed that tumor size, CEA, TNM stage, and combined lymphatic metastasis were negatively correlative with the efficacy of combining sintilimab with neoadjuvant chemotherapy in treating middle to advanced rectal cancer ( < 0.05).
Combining sintilimab with neoadjuvant chemotherapy has good efficacy and safety profile, which is conducive to subsequent surgery; in contrast, larger tumor diameter, higher CEA level, higher TNM stage, and more serious lymphatic metastasis are all independent risk factors affecting treatment sensitivity and can lead to poor efficacy.
基于大数据分析信迪利单抗联合新辅助化疗治疗中晚期直肠癌的疗效。
根据纳入和排除标准,选取2020年1月至2022年1月在张家口市各医院普通外科接受信迪利单抗联合新辅助化疗的43例中晚期直肠癌患者进行回顾性研究。对患者的短期疗效进行科学评估,并分析影响疗效的因素及相关性。
43例入组患者中,30例有区域淋巴结转移,无远处转移;多数患者为Broders II级和TNM III期,均为腺癌;总缓解率为69.77%(30例),无IV级和V级不良反应;根据短期疗效评估结果将患者分为有效组和无效组,对两组暴露的相关因素分析显示,两组在年龄、肿瘤大小、癌胚抗原(CEA)、中性粒细胞与淋巴细胞比值(NLR值)、血小板与淋巴细胞比值(PLR值)、TNM分期及合并淋巴结转移情况方面存在显著差异(P<0.05);单因素分析显示,肿瘤大小、CEA、TNM分期及合并淋巴结转移是影响中晚期直肠癌患者疗效的独立危险因素(P<0.05);通过对上述独立危险因素进行Spearman相关性分析,进一步证实肿瘤大小、CEA、TNM分期及合并淋巴结转移与信迪利单抗联合新辅助化疗治疗中晚期直肠癌的疗效呈负相关(P<0.05)。
信迪利单抗联合新辅助化疗疗效及安全性良好,有利于后续手术;相反,肿瘤直径较大、CEA水平较高、TNM分期较高及淋巴结转移较严重均是影响治疗敏感性的独立危险因素,可导致疗效不佳。