合并症对接受免疫治疗的晚期头颈部癌症患者结局的影响。
Impact of comorbidities on outcomes in patients with advanced head and neck cancer undergoing immunotherapy.
机构信息
Department of Otolaryngology - Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
The Feinstein Institutes for Medical Research, Manhasset, New York, USA.
出版信息
Head Neck. 2023 Nov;45(11):2789-2797. doi: 10.1002/hed.27502. Epub 2023 Sep 8.
OBJECTIVES
To explore the impact of pre-existing comorbidities on immunotherapy response, overall and progression-free survival, and immune-related adverse events (irAEs) of patients with advanced head and neck cancer (HNC) treated with immunotherapy.
PATIENTS AND METHODS
Ninety-three patients treated with immunotherapy were identified and stratified into comorbidity absent or present (CCI < 1 and CCI ≥ 1, respectively) cohorts, and clinical outcomes were compared between these two groups.
RESULTS
Patients with no comorbidities had longer overall survival (aHR = 2.74, 95% CI [1.18, 6.40], p = 0.02) and progression-free survival (aHR = 2.07, 95% CI [1.03, 4.16], p = 0.04) and a higher tumor response rate (32% in CCI < 1 vs. 14% in CC ≥ 1, p = 0.05). Risk for irAEs was higher in the comorbidity absent group (p = 0.05).
CONCLUSION
Comorbidity should be considered as a significant prognostic factor in clinical decision-making for patients with advanced HNC undergoing immunotherapy.
目的
探讨预先存在的合并症对接受免疫治疗的晚期头颈部癌症（HNC）患者的免疫治疗反应、总生存期和无进展生存期以及免疫相关不良事件（irAEs）的影响。
方法
确定了 93 名接受免疫治疗的患者，并将其分为无合并症（CCI<1）和有合并症（CCI≥1）两组，比较这两组患者的临床结局。
结果
无合并症患者的总生存期（aHR=2.74，95%CI[1.18,6.40]，p=0.02）和无进展生存期（aHR=2.07，95%CI[1.03,4.16]，p=0.04）更长，肿瘤反应率更高（CCI<1 组为 32%，CCI≥1 组为 14%，p=0.05）。无合并症组的 irAEs 风险更高（p=0.05）。
结论
在接受免疫治疗的晚期 HNC 患者的临床决策中，应考虑合并症作为一个重要的预后因素。
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