摘要
目的探讨调强放疗(IMRT)联合特瑞普利单抗和铂类方案治疗可切除局部晚期食管鳞状细胞癌(ESCC)的疗效与安全性。方法收集2019年12月—2022年11月在厦门大学附属中山医院接受新辅助治疗的局部晚期ESCC患者120例,根据治疗方法的不同将120例ESCC患者分为对照组(n=60)和观察组(n=60)。对照组接受特瑞普利单抗联合紫衫醇和卡铂治疗,观察组在此基础上应用IMRT治疗。治疗后评价是否可进行手术,比较两组的R0切除率、病理完全缓解(pCR)率、主要病理反应(MPR)率、客观缓解率(ORR)及疾病控制率(DCR)。观察两组围术期相关指标,术后随访24个月比较两组远期疗效及安全性。结果两组患者的新辅助治疗完成率均达100%,观察组的R0切除率为91.67%,pCR率为40.00%,MPR率为61.67%,ORR为86.67%,DCR为96.67%,均显著高于对照组(P<0.05)。两组在手术时间、术中出血量及术后并发症方面比较差异无统计学意义(P>0.05)。随访24个月后,两组的无进展生存率和总生存率比较差异无统计学意义(P>0.05)。两组患者发生贫血、恶心、呕吐、白细胞减少等不良反应情况比较差异无统计学意义(P>0.05)。结论IMRT联合特瑞普利单抗加紫杉醇加卡铂的新辅助治疗模式可提高局部晚期可切除ESCC的临床疗效,且安全性良好。
Objective To Explore the Efficacy and Safety of Intensity-Modulated Radiation Therapy(IMRT)Combined with Trastuzumab and Platinum-Based Regimens in the Treatment of Resectable Locally Advanced Esophageal Squamous Cell Carcinoma(ESCC).Methods Collecting Data on 120 Cases of Locally Advanced Esophageal Squamous Cell Carcinoma(ESCC)Patients Who Received Neoadjuvant Therapy at Zhongshan Hospital Affiliated with Xiamen University from December 2019 to November 2022.120 ESCC patients were divided into control group(n=60)and observation group(n=60)according to different treatment methods.The control group was treated with treprizumab combined with paclitaxel and carboplatin,and the observation group was treated with IMRT on this basis.After treatment,evaluate whether surgery can be performed,and compare the R0 resection rate,pathological complete response(pCR)rate,main pathological response(MPR)rate,objective response rate(ORR),and disease control rate(DCR)of the two groups.The perioperative related indexes of the two groups were observed,and the long-term efficacy and safety of the two groups were compared after 24 months of follow-up.Results The completion rate of new adjuvant therapy in both groups reached 100%.The R0 resection rate,pCR rate,MPR rate,ORR rate,DCR rate and DCR rate in the observation group were 91.67%,40.00%,61.67%,86.67%and 96.67%,respectively,which were significantly higher than those in the control group(P<0.05).There was no significant difference between the observation group and the control group in terms of operation time,intraoperative blood loss and postoperative complications(P>0.05).There was no significant difference in progression free survival rate and overall survival rate between the two groups after 24 months of follow-up(P>0.05).There was no significant difference between the two groups in the occurrence of anemia,nausea,vomiting,leukopenia and other adverse reactions(P>0.05).Conclusion The new adjunctive therapy mode of IMRT combined with treprizumab plus paclitaxel plus carboplatin can improve the clinical efficacy of locally advanced resectable ESCC with good safety.
作者
郭瑞祥
徐辉
郦守国
蔡英杰
吴辉塔
郭群煌
GUO Ruixiang;XU Hui;LI Shouguo;CAI Yingjie;WU Huita;GUO Qunhuang(Department of Radiation Oncology,Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361004,Fujian,China;Department of Thoracic Surgery,Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361004,Fujian,China;Department of Oncology,Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361004,Fujian,China)
出处
《西部医学》
2024年第4期554-559,共6页
Medical Journal of West China
关键词
免疫治疗
调强放疗
新辅助治疗
食管鳞状细胞癌
疗效
安全性
Immunotherapy
Intensity-modulated radiotherapy
Neoadjuvant therapy
Esophageal squamous cell carcinoma
Curative effect
Security
