目的 观察安罗替尼联合特瑞普利单抗二线治疗晚期食管鳞癌患者的疗效和安全性。方法 回顾性收集一线治疗失败后接受安罗替尼联合特瑞普利单抗治疗的晚期食管鳞癌患者35例，观察无进展生存期、疾病缓解率、疾病控制率和不良反应，并观察疗效相关指标。结果 ①35例患者的客观缓解率(objective response rate，ORR)为34。28％，疾病控制率(disease control rate，DCR)为71。43％，中位无进展生存期(middle progress-free survival，mPFS)为4。2个月。②单因素分析结果显示，手术史、肝转移、粒淋比(neutrophil to lymphocyte ratio，NLR)值、ECOG(eastern cooperative oncology group)评分、CD4+/CD8+值是影响 PFS 的相关因素;多因素Cox回归分析结果显示，肝转移、ECOG评分、NLR是影响PFS的独立危险因素。③血清乳酸脱氢酶(lactate de-hydrogenase，LDH)降低人群的ORR高于LDH升高人群。④不良反应以1～2级为主，未出现治疗相关性死亡。结论 安罗替尼联合特瑞普利单抗在晚期食管鳞癌二线治疗中显示出较好的疗效且安全性较好，基线肝转移、ECOG评分以及NLR值可能是疗效的预测指标。
Observation of the efficacy of anlotinib combined with toripalimab in the treat-ment of advanced esophageal squamous cell carcinoma
Objective To observe the efficacy and safety of anlotinib combined with toripalimab in the second-line treatment of ad-vanced esophageal squamous cell carcinoma.Methods A retrospective analysis was conducted on 35 patients with advanced esophageal squamous cell carcinoma who received combined treatment of anlotinib and toripalimab following the failure of first-line therapy.The study observed the progression-free survival,disease response rate,disease control rate,adverse reactions,and further explore the efficacy-related indicators.Results ① The objective response rate(ORR)and disease control rate(DCR)of the 35 patients were 34.28％and 71.43％respectively.The median progression-free survival(mPFS)was 4.2 months.②The results of univariate analysis showed that surgical history,liver metastasis,neutrophil to lymphocyte ratio,NLR,eastern coopera-tive oncology group(ECOG)score and CD4+/CD8+were the related factors affecting PFS.Multivariate Cox regression analy-sis showed that liver metastasis,ECOG score and NLR were independent risk factors for PFS.③The ORR of the population with reduced serum LDH was higher than that of the population with elevated LDH.④Adverse effects were mainly grade 1-2,and there was no treatment-related death.Conclusion Anlotinib combined with toripalimab has shown good efficacy and safety in second-line treatment of advanced esophageal squamous cell carcinoma.Liver metastasis,ECOG score and NLR may be pre-dictors of efficacy.
toripalimabalotinibadvanced esophageal cancerpredictors of clinical efficacy
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