新辅助化疗联合免疫抑制剂对Ⅲ期非小细胞肺癌治疗有效性分析
Efficacy of neoadjuvant chemotherapy combined with immunotherapy in the treatment of stage Ⅲ non-small cell lung cancer
王居巳 1宋伟安 1狄守印 1刘军强 1范博士 1周少华 1岳彩迎 1赵嘉华 1陈思禹 1龚太乾1
作者信息
- 1. 解放军总医院第六医学中心胸外科,北京 100037
- 折叠
摘要
目的 探讨新辅助化学药物治疗(以下简称化疗)联合免疫抑制剂对Ⅲ期非小细胞肺癌的短期治疗效果及安全性.方法 选取2021 年1 月至2024 年2 月解放军总医院第六医学中心的Ⅲ期非小细胞肺癌患者53 例,均行新辅助化疗联合免疫治疗,以 21 d为一个周期,治疗中评估安全性及治疗结束时评估疗效.结果 影像学评估显示,完全缓解 8 例,部分缓解 34 例,疾病稳定 8 例,疾病进展 3 例,客观缓解率为 79.2%,疾病控制率为 94.3%.新辅助治疗后经影像学评估及科室讨论后 53 例患者均实施微创胸腔镜肿瘤切除术,无中转开胸患者,术后并发症 10 例,发生率 18.7%,1 例患者术后出现严重肺部感染致呼吸衰竭死亡.术后组织病理学评估显示,完全缓解 15 例、部分缓解 32 例、疾病稳定 5 例、疾病进展 1 例,主要病理缓解 33 例(62.3%),客观缓解率为 88.7%,疾病控制率 98.1%.不良反应主要为 1、2 级,仅出现 3 例 3 级不良事件,无 4 级不良反应.结论 新辅助化疗联合免疫治疗对于局部晚期非小细胞肺癌具有较好的疗效及安全性,值得进一步推广应用.
Abstract
Objective To investigate the short-term efficacy and safety of neoadjuvant chemotherapy combined with immunosuppressants in the treatment of stage non-small cell lung cancer.Methods Totally 53 patients with stage Ⅲ non-small cell lung cancer in the Sixth Medical Center of the General Hospital from January 2021 to February 2024 were selected to assess the safety during treatment and the efficacy at the end of treatment.Results The imaging evaluation showed that 8 patients had complete response,34 patients had partial response,8 patients had stable disease,and 3 patients had progressive disease.The objective remission rate was 79.2%,and the disease control rate was 94.3%.After neoadjuvant therapy,all 53 patients underwent minimally invasive thoracoscopic tumor resection after imaging and department discussion,and no patients converted to thoracotomy,10 patients had postoperative complications,with the incidence of 18.7%,and only 1 patient died of respiratory failure caused by severe pulmonary infection after surgery.Histopathological evaluation showed that there were 15 cases of complete response,32 cases of partial response,5 cases of stable disease,1 case of disease progression,and 33 cases(62.3%)of the major pathological response,with the objective response rate of 88.7%and the disease control rate of 98.1%.The adverse reactions were mainly grade 1 and 2,and only 3 patients of grade 3 adverse events,and no grade 4 adverse reactions occurred.Conclusion Neoadjuvant immunotherapy combined with chemotherapy has good efficacy and safety in the treatment of locally advanced non-small cell lung cancer,and is worthy of further promotion and application.
关键词
非小细胞肺癌/新辅助治疗/免疫治疗/疗效/安全性Key words
non-small cell lung cancer/neoadjuvant therapy/immunotherapy/efficacy/safety引用本文复制引用
基金项目
北京市科学技术委员会"首都临床特色"项目支持(Z161100000516185)
出版年
2024
NETL
NSTL
万方数据