摘要
目的 评价卡瑞利珠单抗联合卡铂、紫杉醇治疗复发性子宫内膜癌(REC)的近期疗效.方法 回顾性分析2019年1月至2020年10月开滦总医院妇产科收治的104例REC患者的临床资料,按照治疗方式不同分为常规组与研究组,每组各52例.常规组患者应用4～5 mg·m-2·min-1卡铂联合135～175 mg/m2紫杉醇静脉滴注治疗,3周1个疗程,共6个疗程,研究组应用200 mg/次卡瑞利珠单抗联合常规组静脉滴注治疗,1次为1个疗程,共6个疗程.评估两组临床疗效,治疗前后鳞状细胞相关抗原(SCC-Ag)、糖类抗原125(CA125)、人附睾蛋白4(HE4)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-10水平,以及安全性.结果 研究组客观缓解率(ORR)、疾病控制率(DCR)分别为73.08％、94.23％,均明显高于常规组(40.08％、82.69％),差异均有统计学意义(P＜0.05).治疗后,两组患者的SCC-Ag、CA125、HE4水平均较治疗前降低,且研究组患者SCC-Ag、CA125、HE4水平分别为(0.35±0.14)μg/L、(16.23±3.18)U/mL、(30.51±3.77)kU/L,均低于常规组[(0.46±0.17)μg/L、(22.66±3.41)U/mL、(37.51±3.20)kU/L],差异均有统计学意义(P＜0.05).治疗后,两组患者TNF-α、IL-6水平均较治疗前升高,IL-10水平均较治疗前降低,研究组TNF-α、IL-6水平分别为(1.22±0.40)、(65.62±4.78)pg/mL,均低于常规组[(1.42±0.31)、(71.30±4.62)pg/mL],研究组 IL-10 水平为(35.62±4.25)pg/mL,高于常规组[(29.35±3.21)pg/mL],差异均有统计学意义(P＜0.05).两组消化道反应、骨髓抑制、皮疹、肝脏功能异常、疲乏发生情况比较,差异均无统计学意义(P＞0.05).结论 卡瑞利珠单抗联合卡铂、紫杉醇的临床疗效高于单纯应用卡铂联合紫杉醇治疗,可改善肿瘤标志物水平,调节机体炎症因子水平,用药安全性良好,可作为REC的临床用药备选方案.
Abstract
Objective To evaluate the short-term efficacy of carrelizumab combined with carboplatin and paclitaxel in the treatment of recurrent endometrial carcinoma(REC).Methods The clinical data of 104 patients with REC admitted to the Department of Obstetrics and Gy-necology,Kailuan General Hospital from January 2019 to October 2020 were retrospectively analyzed,and they were divided into the conventional group and the study group with 52 cases in each group according to different treatment methods.Patients in the conventional group was treated with 4～5 mg·m-2·min-1 carboplatin combined with 135-175 mg/m2 paclitaxel intravenous infusion for3 weeks/course,a total of 6 courses;the study group was treated with 200 mg/time carrellizumab combined with the conventional group intravenous infusion once/course,a total of 6 cour-ses.The clinical efficacy,levels of squamous cell associated antigen(SCC-Ag),carbohydrate antigen 125(CA125),human epididymal 4(HE4),tumor necrosis factor-α(TNF-α),interleukin(IL)-6,and IL-10 before and after treatment,and safety of the two groups were e-valuated.Results The objective remission rate(ORR)and disease control rate(DCR)of the research group were 73.08％and 94.23％,re-spectively,which were significantly higher than those of the conventional group(40.08％and 82.69％),and the differences were statistically sig-nificant(P＜0.05).After treatment,the levels of SCC-Ag,CA125,and HE4 in two groups were lower than those before treatment,and the levels of SCC-Ag,CA125,and HE4 in the study group were(0.35±0.14)μg/L,(16.23±3.18)U/L,and(30.51±3.77)kU/L,re-spectively,lower than those in the control group[(0.46±0.17)μg/L,(22.66±3.41)U/L,and(37.51±3.20)kU/L],and the differ-ences were statistically significant(P＜0.05).After treatment,the levels of TNF-α and IL-6 in two groups were higher than those before treatment,while the levels of IL-10 in two groups were higher than those before treatment,the levels of TNF-α and IL-6 in the study group were(1.22±0.40)and(65.62±4.78)pg/mL,respectively,which were lower than those in the control group[(1.42±0.31)and(71.30±4.62)pg/mL],the levels of IL-10 in the study group were(35.62±4.25)pg/mL,which was higher than those in the control group[29.35±3.21)pg/mL],and the differences were statistically significant(P＜0.05).There were no differences in digestive tract reaction,bone mar-row depression,skin rash,liver dysfunction and fatigue between the two groups(P＞0.05).Conclusion The clinical efficacy of carrilizumab combined with carboplatin and paclitaxel is higher than that of carboplatin combined with paclitaxel alone,which can improve the level of tumor markers and reduce the damage of inflammatory factors,and the drug safety is good,which can be used as a clinical drug option for REC.
基金项目
河北省2019年度医学科学研究课题计划项目(20191328)
NETL
NSTL
万方数据