Jiao Jin, Li Wen-Wen, Shang Yan-Hong, Li Xiao-Fang, Jiao Meng
Jin Jiao, Department of Oncology, Affiliated Hospital of Hebei University; Hebei Provincial Key Laboratory of Tumor Radiochemotherapy Mechanism and Procedure Research, Baoding, Hebei 071000, P.R. China.
Wen-wen Li, Department of Oncology, Affiliated Hospital of Hebei University; Hebei Provincial Key Laboratory of Tumor Radiochemotherapy Mechanism and Procedure Research, Baoding, Hebei 071000, P.R. China.
Pak J Med Sci. 2023 Mar-Apr;39(2):404-408. doi: 10.12669/pjms.39.2.6365.
To evaluate the clinical effects of chemotherapy combined with immunotherapy in patients with advanced non-small-cell lung cancer (NSCLC) and the effect on their nutritional status and immune function.
Total 120 patients with advanced NSCLC admitted to Affiliated Hospital of Hebei University from May 2019 to October 2021 were randomly divided into two groups (n= 60, respectively). Patients in the control group were treated by chemotherapy with cisplatin-paclitaxel (TP) alone: 120 mg/m paclitaxel was used on d1; and 25mg/m cisplatin (CDDP) was used for more than two hour, once every 14 days, for three consecutive three cycles. Patients in the study group were additionally given 200 mg sindilizumab by intravenous drip, once every three weeks. The contrastive analysis of clinical effects, the incidence of adverse reactions, improvement of the nutrient index and the changes in levels of CD3, CD4, CD8, and CD4/CD8 in T-lymphocyte subsets was performed between the two groups.
The overall response rate (ORR) was 80% and 61% in the study group and the control group, respectively; and the difference was statistically significant (p=0.03); the contrast analysis of the incidence of post-treatment adverse drug reactions (ADRs) in patients in the two groups suggested that the incidence of adverse reactions was 33.3% and 45% in the study group and the control group, respectively; and the difference was not statistically significant (p=0.19). After the treatment, the improvement of hemoglobin, albumin, serum iron and ferritin levels in the study group was more significant than that in the control group; and the difference was statistically significant (p < 0.05). After the treatment, the levels of CD3, CD4 and CD4/CD8 in the study group were much higher than those in the control group; and the difference was statistically significant (p < 0.05).
Chemotherapy combined with immunotherapy is effective in treating patients with advanced NSCLC without increasing the incidence of adverse reactions, and can significantly improve their nutritional status and T-lymphocyte function. This therapeutic regimen is of much higher clinical value than the chemotherapy-only regimen.
评估化疗联合免疫疗法对晚期非小细胞肺癌(NSCLC)患者的临床疗效及其对营养状况和免疫功能的影响。
选取2019年5月至2021年10月在河北大学附属医院收治的120例晚期NSCLC患者,随机分为两组(每组n = 60)。对照组患者仅接受顺铂-紫杉醇(TP)化疗:第1天使用120mg/m²紫杉醇;25mg/m²顺铂(CDDP)持续输注超过两小时,每14天一次,连续三个周期。研究组患者在化疗基础上,额外静脉滴注200mg信迪利单抗,每三周一次。对比分析两组患者的临床疗效、不良反应发生率、营养指标改善情况以及T淋巴细胞亚群中CD3、CD4、CD8和CD4/CD8水平的变化。
研究组和对照组的总缓解率(ORR)分别为80%和61%;差异具有统计学意义(p = 0.03);两组患者治疗后药物不良反应(ADR)发生率的对比分析表明,研究组和对照组的不良反应发生率分别为33.3%和45%;差异无统计学意义(p = 0.19)。治疗后,研究组血红蛋白、白蛋白、血清铁和铁蛋白水平的改善程度明显高于对照组;差异具有统计学意义(p < 0.05)。治疗后,研究组CD3、CD4和CD4/CD8水平显著高于对照组;差异具有统计学意义(p < 0.05)。
化疗联合免疫疗法治疗晚期NSCLC患者有效,且不增加不良反应发生率,能显著改善患者营养状况及T淋巴细胞功能。该治疗方案的临床价值远高于单纯化疗方案。