复旦学报(医学版)2025,Vol.52Issue(1) :107-113.DOI:10.3969/j.issn.1672-8467.2025.01.014

I-125粒子植入改善接受抗PD-1联合化疗的胰腺癌患者的预后

I-125 seed implantation improves the prognosis of pancreatic cancer patients treated with anti-PD-1 combined chemotherapy

闵科 蒋嘉萍 王维民 王云帆 汤月华 陈红 姚强 金俊
复旦学报(医学版)2025,Vol.52Issue(1) :107-113.DOI:10.3969/j.issn.1672-8467.2025.01.014

I-125粒子植入改善接受抗PD-1联合化疗的胰腺癌患者的预后

I-125 seed implantation improves the prognosis of pancreatic cancer patients treated with anti-PD-1 combined chemotherapy

闵科 1蒋嘉萍 1王维民 1王云帆 1汤月华 1陈红 1姚强 1金俊1
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作者信息

  • 1. 江苏大学附属宜兴医院肿瘤科 宜兴 214200
  • 折叠

摘要

目的 评估接受I-125粒子植入联合抗PD-1单克隆抗体+化疗的晚期胰腺导管腺癌(pancreatic ductal adenocarcinoma,PDAC)患者的预后和安全性.方法 回顾性分析2021年1月至2023年6月于江苏大学附属宜兴医院接受抗PD-1联合化疗治疗的Ⅳ期转移性PDAC患者,根据是否接受I-125粒子植入分为:I-125粒子植入联合抗PD-1 单克隆抗体和化疗组(I-125 seed implantation+anti-PD-1 monoclonal antibody+chemotherapy group,IPC组),抗PD-1单克隆抗体和化疗组(anti-PD-1 monoclonal antibody+chemotherapy group,PC组).随访时间为2~24个月,中位随访时间为9个月.结合外周血生物标志物分析患者的预后.通过流式细胞术初步分析不同治疗组患者的外周淋巴细胞亚群.结果 共纳入 13 名患者,其中IPC组 5 名,PC组 8 名.IPC组的无进展生存期(progression-free survival,PFS)和总生存期(overall survival,OS)明显长于PC组.IPC组的治疗安全性和不良反应在可控范围内.中性粒细胞-淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)和CD4/CD8比值表明IPC患者的预后更好.与PC组患者相比,IPC组的患者治疗后的调节性T细胞(regulatory T cells,Treg)和活化的调节性T细胞(active regulatory T cells,aTreg)水平降低.结论 治疗中植入I-125粒子可改善接受抗PD-1单克隆抗体+化疗的晚期PDAC患者的预后,且患者治疗后的循环aTreg细胞水平降低,联合治疗具有良好的安全性.

Abstract

Objective To evaluate the prognosis and safety of patients with advanced pancreatic ductal adenocarcinoma(PDAC)who received I-125 seed implantation in treatment with anti-PD-1 monoclonal antibody+chemotherapy.Methods A retrospective analysis was conducted on patients with stage Ⅳ metastatic PDAC who received anti-PD-1 combined chemotherapy treatment at Yixing Hospital,Jiangsu University from Jan 2021 to Jun 2023.Patients were divided into two groups based on whether they received I-125 seed implantation:the I-125 seed implantation+anti-PD-1 monoclonal antibody+Chemotherapy group(IPC group)and the anti-PD-1 monoclonal antibody+chemotherapy group(PC group).The follow-up period ranged from 2 to 24 months,with a median follow-up time of 9 months.The prognosis of patients was analysed in combination with peripheral blood biomarkers.The peripheral lymphocyte subsets of patients in different treatment groups were preliminarily analysed by flow cytometry.Results A total of 13 patients were included,with 5 in the IPC group and 8 in the PC group.Progression-free survival(PFS)and overall survival(OS)in the IPC group were significantly longer than those in the PC group.The treatment in the IPC group was relatively safe,adverse reactions were controllable.The neutrophil-lymphocyte ratio(NLR)and CD4/CD8 ratio indicated that the prognosis of the IPC patients was better.The levels of regulatory T cells(Treg)and active regulatory T cells(aTreg)cells in the IPC patients were reduced after treatment compared with those of the PC patients.Conclusion The addition of I-125 seed implantation can improve the prognosis of patients with advanced PDAC who receive anti-PD-1 monoclonal antibody+chemotherapy,the post-treatment levels of patients'circulating aTreg cells are reduced,and the combination therapy has good safety.

关键词

胰腺癌/I-125粒子/免疫治疗/放疗/调节性T细胞(Treg)

Key words

pancreatic cancer/I-125 seed/immunotherapy/radiotherapy/regulatory T cells(Treg)

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出版年

2025
复旦学报(医学版)
复旦大学

复旦学报(医学版)

CSCD北大核心
影响因子:1.206
ISSN:1672-8467
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