卡瑞利珠单抗联合替吉奥胶囊对晚期食管鳞癌的疗效及安全性研究

Efficacy and safety of camrelizumab combined with tegafur, gimeracil and oteracil potassium capsule in treating advanced esophageal squamous cell carcinoma

  • 摘要:
    目的 分析卡瑞利珠单抗联合替吉奥胶囊对晚期食管鳞癌的疗效及安全性。
    方法 将2021年7月—2022年6月在本院治疗的80例晚期食管鳞癌患者根据治疗方法分为替吉奥组(n=44)和联合组(n=36)。替吉奥组口服替吉奥胶囊, 联合组在替吉奥组基础上加用卡瑞利珠单抗注射液治疗。比较2组患者治疗前后肿瘤标志物、免疫细胞群水平; 评估2组患者生活质量; 分析2组治疗效果及药物不良反应。
    结果 治疗后, 2组鳞状细胞癌抗原(SCC-Ag)、细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)、糖类抗原125(CA125)、CD8+、美国东部肿瘤协作组(ECOG)体能状态评分均降低, CD3+、CD4+、CD4+/CD8+、生活质量评分量表(QOL)评分、卡氏评分量表(KPS)评分升高, 且联合组上述指标较替吉奥组变化更大,差异有统计学意义(P<0.05)。替吉奥组治疗有效率为34.09%, 疾病控制率为72.73%; 联合组治疗有效率为63.89%, 疾病控制率为83.33%; 联合组治疗有效率高于替吉奥组,差异有统计学意义(P<0.05)。替吉奥组与联合组均出现胃肠道不适、心血管不良反应、骨髓抑制、脱发、甲状腺功能异常、皮疹、水肿等不良反应,但组间差异无统计学意义(P>0.05)。替吉奥组平均无进展生存期(PFS)为(3.13±0.94)个月,平均总生存期(OS)为(6.05±2.38)个月; 联合组平均PFS为(5.08±1.67)个月,平均OS为(9.01±3.54)个月; 联合组平均PFS、OS长于替吉奥组,差异有统计学意义(P<0.05)。
    结论 卡瑞利珠单抗联合替吉奥胶囊能有效缓解晚期食管鳞癌患者临床症状,减轻痛苦,提高生活质量。

     

    Abstract:
    Objective To analyze the efficacy and safety of camrelizumab combined with tegafur, gimeracil and oteracil potassium capsule in treating advanced esophageal squamous cell carcinoma.
    Methods Eighty patients with advanced esophageal squamous cell carcinoma treated in the hospital from July 2021 to June 2022 were divided into tegafur, gimeracil and oteracil potassium group (n=44) and combined group (n=36) according to the therapeutic methods. The tegafur, gimeracil and oteracil potassium group was orally treated with tegafur, gimeracil and oteracil potassium capsule, while the combined group was treated with camrelizumab injection on the basis of the tegafur, gimeracil and oteracil potassium group. Tumor markers and immune cell population levels were compared between the two groups before and after treatment; the quality of life was evaluated in both groups; the therapeutic effect and adverse reactions of drugs were analyzed between the two groups.
    Results After treatment, the squamous cell carcinoma antigen(SCC-Ag), cytokeratin 19 fragment (CYFRA21-1), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), CD8+, and the performance status of the Eastern Cooperative Oncology Group (ECOG) decreased significantly in both groups, while CD3+, CD4+, CD4+/CD8+, score of the Quality of Life (QOL), and score of the Karnofsky Scale increased significantly, and the improvement of the above indicators in the combined group were significantly greater than those in the tegafur, gimeracil and oteracil potassium group (P<0.05). The effective rate was 34.09% and the disease control rate was 72.73% in the tegafur, gimeracil and oteracil potassium group, while the effective rate was 63.89% and the disease control rate was 83.33% in the combined group; the effective rate of the combined group was significantly higher than that of thetegafur, gimeracil and oteracil potassium group (P<0.05). Both the tegafur, gimeracil and oteracil potassium group and the combined group occurred adverse reactions such as gastrointestinal discomfort, cardiovascular adverse reactions, myelosuppression, hair loss, thyroid dysfunction, rash and edema, but there were no significant differences between the two groups (P>0.05). The mean progression-free survival (PFS) was (3.13±0.94) months and the mean overall survival (OS) was (6.05±2.38) months in the tegafur, gimeracil and oteracil potassium group, while the mean PFS was (5.08±1.67) months and the mean OS was (9.01±3.54) months in the combined group; the mean PFS and OS in the combined group were significantly longer than those in the tegafur, gimeracil and oteracil potassium group (P<0.05).
    Conclusion Camrelizumab combined with tegafur, gimeracil and oteracil potassium capsule can effectively alleviate clinical symptoms, reduce pain and improve the quality of life in patients with advanced esophageal squamous cell carcinoma.

     

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