Intensity Modulated Conformal Radiotherapy Combined with PD-1/PD-L1 Inhibitors in Treatment of Advanced Rectal Cancer
Objective To observe the efficacy and adverse reactions of intensity modulated conformal ra-diotherapy combined with programmed death receptor-1(PD-1)/programmed death receptor-ligand 1(PD-L1)inhibitors in the treatment of middle and advanced rectal cancer.Methods Data of 82 patients with advanced rectal cancer who received intensity modulated conformal radiotherapy from January 2018 to June 2020 were reviewed,including 33 patients receiving intensity modulated conformal radiotherapy alone(mere radiotherapy group for short)and 49 patients receiving intensity modulated conformal radiotherapy combined with PD-1/PD-L1 inhibitors(combined treatment group for short).The short and long term ef-ficacy,levels of tumor M2 pyruvate kinase(TuM2-PK)and fatty acid synthetase(FAS)before and after treatment,and adverse reactions were compared between the two groups.Results The overall response rate(ORR)and disease control rate(DCR)of the combined treatment group were 32.65％and 83.67％,respectively,which were higher than those of the mere radiotherapy group(21.21％and 72.73％)(P＜0.05).The 1-year,2-year and 3-year survival rates in the combined treatment group were 89.80％,73.47％and 57.14％,respectively,which were higher than those in the mere radiotherapy group(72.73％,51.52％and 42.42％)(P＜0.05).Follow-up to April 30,2024,the mean survival time of the combined treatment group was(35.93±8.22)months,which was significantly longer than(29.13±6.57)months in the mere radiotherapy group,(P＜0.05).There was no significant difference in the incidence of gas-trointestinal reactions,myelosuppression,liver and kidney function damage and radiation dermatitis be-tween the two groups(P＞0.05).Conclusion Intensity modulated conformal radiotherapy combined with PD-1/PD-L1 inhibitors can improve the short and long term therapeutic effect in the treatment of middle and advanced rectal cancer without increasing adverse reactions.
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