Efficacy of Interstitial Brachytherapy Combined with PD-1 Monoclonal Antibody in Treatment of Advanced Non-Small Cell Lung Cancer and Related Prognostic Factors of Patients
[Objective]To investigate the efficacy of interstitial brachytherapy combined with PD-1 monoclonal antibody in treatment of advanced non-small cell lung cancer(NSCLC)and to analyze the influencing factors of patient prognosis.[Methods]Seventy patients with advanced NSCLC,who received a first line or higher treatment regimen and the disease progressed,were from January 2020 to December 2023.All patients un-derwent a treatment regimen of interstitial brachytherapy combined with PD-1 monoclonal antibody.Patients were followed up and the short-term efficacy and long-term outcomes were evaluated.The factors affecting the overall survival(OS)of patients were analyzed with Cox multivariate regression.[Results]Patients received a median treatment cycle of 4.62±1.12,there was no case of complete response,12 cases(17.14％)of partial response,45 cases(64.29％)of stable disease,and 13 cases(18.57％)of progressive disease.The objective response rate was 17.14％,and the total effective rate was 81.43％.The median progression-free survival of the patient was 4 months,and the median OS was 14 months.Patient had good tolerance to the treatment,and no fatal adverse reaction was observed.There were 5 patients with severe adverse reactions of grades 3～4,accounting for 7.14％.The Log-rank test results show that the patients with ECOG score 0～1,C-reactive protein(CRP)≤10 mg/mL,neutrophil-to-lymphocyte ratio(NLR)≤5 and positive PD-L1 had a longer OS.Cox multivariate analysis showed that ECOG score,CRP,NLR and positive PD-L1 were independent influencing factors for OS in NSCLC patients(P＜0.05).[Conclusion]The interstitial brachytherapy combined with PD-1 monoclonal antibody provides an effective treatment option for advanced NSCLC patients.ECOG score,CRP NLR,and positive PD-L1 are predictors for clinical outcomes of patients receiving the combination regimen.
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