Ma FaQiang, Qi ZhengJun, Liao GuangHui, Zhao LiLi, Su XiaLu, Dong ChangFen, Lu FangYang, Sun Yi
Department of Oncology, The Second Affiliated Hospital of Guizhou Medical University, Kaili, Guizhou, China.
Department of Oncology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.
Medicine (Baltimore). 2025 Feb 7;104(6):e41306. doi: 10.1097/MD.0000000000041306.
Although chemotherapy, targeted therapy, and antiangiogenic drugs have become the cornerstones of treatment for advanced non-small-cell carcinoma (NSCLC) in clinical practice, the emergence of immune checkpoint inhibitors (such as PD-1 inhibitors) in recent years has also provided new options for the treatment of NSCLC. To explore whether PD-1 inhibitors combined with recombinant human endostatin and chemotherapy followed by IMRT have a certain curative effect in the treatment of advanced NSCLC. We retrospectively analyzed 47 patients with stage IIIB, IIIC, and IV NSCLC admitted to our hospital from August 2022 to June 2023. According to the treatment method, the patients were divided into an observation group (24 cases) and a control group (23 cases). The control group only received recombinant human endostatin 105 g and chemotherapy followed by IMRT; the observation group received domestic PD-1 inhibitors, 200 mg, and chemotherapy followed by IMRT on the basis of the treatment plan of the control group. After treatment, the objective response rate (ORR), disease control rate, overall survival, progression-free survival (PFS), duration of response, and incidence of adverse reactions were compared. After treatment, the ORR and disease control rate of the observation group were higher than those of the control group; compared with the control group, the PFS, overall survival, and duration of response period of the observation group were longer (P < .05); the incidence of adverse reactions in the observation group was significantly lower than that in the control group (P < .05). After chemotherapy, the CD3+ and CD4+ index of the observation group was significantly increased, the CD3+ CD8+ was slightly lower than that of the control group, without statistical significance, and the ratio of CD4/CD8 was higher than that of the control group, and the interleukin-2 index was significantly better than that of the routine group, P < .05. PD-1 inhibitor combined with recombinant human endostatin and chemotherapy followed by IMRT in the treatment of advanced NSCLC can significantly improve the ORR and prolong the PFS of patients, and the adverse reactions are controllable. The results of our study may provide help for the treatment strategies of patients with refractory advanced NSCLC, and are worthy of promotion and use.
尽管化疗、靶向治疗和抗血管生成药物已成为临床实践中晚期非小细胞肺癌（NSCLC）治疗的基石，但近年来免疫检查点抑制剂（如PD-1抑制剂）的出现也为NSCLC的治疗提供了新的选择。为探讨PD-1抑制剂联合重组人血管内皮抑素及化疗后行调强放疗（IMRT）在晚期NSCLC治疗中是否具有一定疗效。我们回顾性分析了2022年8月至2023年6月我院收治的47例IIIB期、IIIC期和IV期NSCLC患者。根据治疗方法，将患者分为观察组（24例）和对照组（23例）。对照组仅接受重组人血管内皮抑素105μg及化疗后行IMRT；观察组在对照组治疗方案的基础上接受国产PD-1抑制剂200mg及化疗后行IMRT。治疗后，比较客观缓解率（ORR）、疾病控制率、总生存期、无进展生存期（PFS）、缓解持续时间及不良反应发生率。治疗后，观察组的ORR和疾病控制率高于对照组；与对照组相比，观察组的PFS、总生存期和缓解期持续时间更长（P<0.05）；观察组不良反应发生率明显低于对照组（P<0.05）。化疗后，观察组的CD3+和CD4+指数明显升高，CD3+CD8+略低于对照组，无统计学意义，CD4/CD8比值高于对照组，白细胞介素-2指数明显优于常规组，P<0.05。PD-1抑制剂联合重组人血管内皮抑素及化疗后行IMRT治疗晚期NSCLC可显著提高患者的ORR并延长PFS，且不良反应可控。我们的研究结果可能为难治性晚期NSCLC患者的治疗策略提供帮助，值得推广应用。
