食管癌围手术期免疫治疗致免疫相关不良反应的临床特征分析
Analysis of clinical characteristics of immune-related adverse events caused by perioperative immunotherapy for esophageal cancer
刘金玉 1蔡乐 1张筱璇 1白楠 1汤智慧 1王天琳1
作者信息
- 1. 解放军总医院 医疗保障中心药剂科,北京 100853
- 折叠
摘要
目的 探讨食管癌围手术期免疫治疗致免疫相关不良反应(irAEs)的临床特征,为irAEs管理提供参考.方法 收集2020年3月至2022年8月解放军总医院第一医学中心收治的食管癌围手术期接受PD-1抑制剂治疗的病历资料,分析发生irAEs患者的临床特征、干预措施及转归,探讨围手术期免疫治疗所致irAEs的管理要点.结果 共纳入66例患者,有19例(28.79%)患者发生irAEs,累计24例次,涉及多个系统,多为轻、中度不良反应,采用对症处理或激素治疗后预后良好,年龄≤60岁患者irAEs发生率显著升高,3例患者因irAEs导致手术延误或停用免疫治疗.结论 食管癌患者围手术期应用PD-1抑制剂总体安全性良好,临床应加强管理,确保围手术期免疫治疗的安全使用,充分促进临床结局的正向改善.
Abstract
Objective To analyze the clinical characteristics of immune-related adverse events(irAEs)causde by periop-erative immunotherapy for esophageal cancer,and provide reference for irAEs management.Methods The medical records of esophageal cancer patients receiving PD-1 inhibitors during the perioperative period in the first medical center of Chinese PLA General Hospital from March 2020 to August 2022 were collected.Clinical characteristics,intervention and outcome of irAEs were analyzed,and the management of irAEs caused by perioperative immunotherapy were discussed.Results A total of 66 patients were included.Nine patients(28.79%)experienced irAEs.IrAEs occurred 24 times,involving multiple systems.Most of the cases were mild or moderate,and symptoms could be improved after symptomatic treatment or glucocorticoid in-tervention.The incidence of irAEs in patients aged≤60 years was significantly increased.Three patients delayed operation or stopped immunotherapy due to irAEs.Conclusions The perioperative application of PD-1 inhibitors in esophageal cancer pa-tients had good safety.Clinical management should be strengthened to ensure the safety of perioperative immunotherapy and fully promote the improvement of clinical outcomes.
关键词
食管癌围手术期/免疫相关不良反应/程序性死亡受体1抑制剂/不良反应管理建议Key words
perioperative period of esophageal cancer/immune-related adverse events/programmed death-1 inhibitor/management recommendations for adverse events引用本文复制引用
基金项目
首都卫生发展科研专项(首发2022-2-5011)
出版年
2024
NETL
NSTL
万方数据