摘要
Abstract
Objective To investigate the clinical efficacy and safety of deep hyperthermia combined with Endostar and nab-PC regimen(albumin-bound paclitaxel+carboplatin)in the treatment of advanced lung squamous cell carcinoma with negative driver gene and negative expression of programmed cell programmed death-ligand 1(PD-L1).Methods Ninety-six patients with driver gene-negative and PD-L1-negative advanced lung squamous cell carcinoma admitted to our hospital between June 2020 and June 2023 were selected as the study objects,and were divided into control group(48 cases)and ob-servation group(48 cases)according to random number table method.The control group was treated with Endostar and nab-PC regimen,and the observation group was treated with deep hyperthermia combined with Endostar and nab-PC regimen.Both groups were treated with a course of 3 weeks for 4 consecutive courses.The serum levels of squamous cell carcinoma antigen(SCCA),neuron-specific enolase(NSE),cytokeratin fragment 19(CYFRA21-1),matrix metalloproteinase-2(MMP-2),MMP-9,vascular endothelial growth factor(VEGF),epidermal growth factor receptor(EGFR),CC chemokine li-gand 5(CCL5),and CCL20 were compared before and after treatment.The quality of life of the two groups was evaluated by the Functional Assessment of Cancer Treatment-Lung(FACT-L)before and after treatment.Drug-related adverse reac-tions,short-term efficacy,survival outcomes were compared between the two groups,and the hyperthermia-related compli-cations in the observation group were analyzed.Results After treatment,serum levels of tumor markers(SCCA,NSE,CY-FRA21-1),matrix metalloproteinases(MMP-2,MMP-9),growth factors(VEGF,EGFR),and chemokines(CCL5,CCL20)significantly decreased in both groups compared to pretreatment levels,with the observation group showing significantly lower levels than the control group(all P<0.05).The FACT-L scores were significantly increased post-treatment in both groups,with higher scores in the observation group(P<0.05).No significant differences were observed in drug-related ad-verse reactions(e.g.,myalgia/arthralgia,thrombocytopenia,gastrointestinal reactions)between the two groups.Among the 48 patients of the observation group,1 patient experienced transient hyperthermia during treatment,3 had local skin red-ness and swelling,and 2 reported subcutaneous pain and induration after deep hyperthermia;all complications were man-ageable and did not interrupt treatment.The observation group exhibited higher objective response rate(ORR)and disease control rate(DCR)than the control group(P<0.05).The median progression-free survival and median overall survival in the observation group were 6.9 months(95％CI:4.76-8.41)and 14.2 months(95％CI:10.72-19.62),respectively,which were significantly longer than those in the control group[(4.3 months(95％CI:3.31-6.54)and 10.3 months(95％CI:6.69-14.18)]were prolonged,the difference was statistically significant(P<0.05).Conclusion Deep hyperthermia combined with Endostar and nab-PC regimen significantly reduces serum tumor-related factor levels,improves quality of life and progno-sis,and demonstrates good safety,offering a novel therapeutic option for driver gene-negative/PD-L1-negative advanced lung squamous cell carcinoma patients.关键词
肺鳞癌/深部热疗/程序性死亡蛋白配体-1/恩度/化疗/驱动基因Key words
Lung squamous cell carcinoma/Deep hyperthermia/Programmed death-ligand 1/Endostar/Chemothera-py/Driver gene分类
临床医学
