肿瘤预防与治疗2024，Vol.37Issue(4)：312-319,8.DOI:10.3969/j.issn.1674-0904.2024.04.006
替雷利珠单抗联合放化疗治疗局部晚期食管鳞癌的疗效和不良反应分析
Efficacy and Adverse Effects of Tislelizumab plus Chemoradiotherapy in Locally Advanced Esophageal Squamous Cell Carcinoma
摘要
Abstract
Objective:To analyze the efficacy and adverse effects of tislelizumab plus chemoradiotherapy in the first-line treatment of locally advanced esophageal squamous cell carcinoma(ESCC).Methods:We retrospectively analyzed the clin-ical data of patients admitted to our hospital from February 2019 to December 2021 with locally advanced ESCC who were surgically unresectable or unwilling to undergo surgical resection.The patients whether or not were administrated with tisleli-zumab during chemoradiotherapy were assigned to combination group and chemoradiotherapy group.The combination group(18 patients)received 4 to 6 cycles of albumin-conjugated paclitaxel and platinum-based chemotherapy before being admin-istrated with tislelizumab followed by concomitant chemoradiotherapy.The chemoradiotherapy group(13 patients)received 4 to 6 cycles of albumin-conjugated paclitaxel and platinum-based chemotherapy before being administrated tegafur followed by radiotherapy.Efficacy and safety of tislelizumab combined with chemoradiotherapy was initially evaluated.Results:Thirty-one patients were enrolled,18 in the combination group and 13 in the chemoradiotherapy group,including 21 men and 10 women aged from 55 to 79 years,with median age of 67 years.Of the 31 patients,9 cases were in T3N+stage and 22 cases in T4N0～3 stage;5 cases were in the cervical segment,8 cases in the upper thoracic segment,8 cases in the middle thoracic segment,7 cases in the lower thoracic segment,and 3 cases in the gastroesophageal junction.As of October 2023,the mini-mum follow-up for patients was 20.3 months.There were 4 cases of complete response(CR),11 cases of partial response(PR),and 3 cases of stable disease(SD)in the combination group,and 1 case of CR,4 cases of PR,7 cases of SD,and 1 case of progressive disease(PD)in the chemoradiotherapy group.Objective response rate was 83.33％(15/18)in com-bination group,and 38.46％(5/13)in the chemoradiotherapy group,and the difference was statistically significant(P=0.20);the mPFS was 36.5 months(95％CI:25.75～47.25)in the former,and 24.0 months(95％CI:21.05～26.95)in the latter,and the difference was statistically significant(P=0.021);the rates of 1-year progression-free survival were 100％in the former and 92.3％in the latter,and the difference was statistically significant(OR=1.08,95％CI:0.93～1.27,P=0.419);the rates of 2-year progression-free survival were 77.0％in the former and 39.2％in the latter,and the difference was statistically significant(OR=5.85,95％CI:1.22～27.99,P=0.033).There were no statistically signifi-cant differences in CD3+T cells,CD4+T cells,CD8+T cells,and the CD4+/CD8+T ratio between the two groups before treatment(both P＞0.05).After treatment,the rate of CD4+T and the CD4+/CD8+T ratio in the combination group were significantly higher than those in the chemoradiotherapy group(P=0.036,P=0.002);and the rate of CD8+T was signifi-cantly lower in the former than that in the latter(P=0.048).There were no significant differences between the two groups in terms of radioactive esophagitis,bone marrow suppression,loss of appetite,and radioactive pneumonia.The incidence of hypothyroidism,ranging from grade 1 to 2,was 55.56％in the combination group and 15.38％in the chemoradiotherapy group,and the difference was statistically significant(P=0.032).Conclusion:The first-line chemoradiotherapy of tisleli-zumab combined with albumin-conjugated paclitaxel and platinum for locally advanced ESCC is relatively effective,and the adverse effects are controllable,which is profitable for the survival of ESCC patients.关键词
食管鳞癌/替雷利珠单抗/同步放化疗/白蛋白结合型紫杉醇Key words
Esophageal squamous cell carcinoma/Tislelizumab/Concomitant chemoradiotherapy/Albumin-conjugated paclitaxel分类
医药卫生引用本文复制引用
胡俊霞,刘益民,朱林,董婷婷,胡筱,刘德林,张慧敏..替雷利珠单抗联合放化疗治疗局部晚期食管鳞癌的疗效和不良反应分析[J].肿瘤预防与治疗,2024,37(4):312-319,8.基金项目
白求恩基金(编号:BCF-XD-JC-20221205-17)This study was supported by grants from Bethune Charitable Foundation(No.BCF-XD-JC-20221205-17). （编号:BCF-XD-JC-20221205-17）
