卡瑞利珠单抗+白蛋白紫杉醇+奈达铂/顺铂治疗老年晚期食管癌的临床疗效观察

Clinical observation of carelizumab combined with albumin paclitaxel and nedaplatin/cisplatin in treatment of elderly patients with advanced esophageal cancer

摘要:

目的 探讨卡瑞利珠单抗+白蛋白紫杉醇+奈达铂/顺铂治疗老年晚期食管癌的疗效和安全性。方法 回顾性分析2018年10月—2020年8月安徽省立医院62例行一线化疗的晚期食管癌患者的临床资料。依据治疗方案的不同分为A组（30例）和B组（32例）。A组患者接受卡瑞利珠单抗（200 mg d1）+白蛋白紫杉醇（0.1 g d1、d5）+奈达铂（70 mg/m² d2）/顺铂方案（30 mg d1～d4）；B组患者接受白蛋白紫杉醇+奈达铂/顺铂方案。比较两组近期疗效、肿瘤标志物［癌胚抗原（CEA）、鳞状细胞癌抗原（SCC）］水平、毒副反应事件发生率及预后生存情况。结果 A组客观缓解率高于B组（P <0.05）；两组治疗前后CEA、SCC差值比较，差异有统计学意义（P <0.05），A组治疗前后CEA、SCC的差值高于B组；两组治疗期间腹泻、胃肠道反应、骨髓抑制、肝肾功能损伤总发生率比较，差异无统计学意义（P >0.05）；A组存活率高于B组（P <0.05）。结论 老年晚期食管癌患者采用卡瑞利珠单抗+白蛋白紫杉醇+奈达铂/顺铂治疗可提高临床疗效，降低肿瘤标志物水平，提高患者近期生存率，且安全性良好。

Abstract:

Objective To investigate the efficacy and safety of camrelizumab combined with albumin paclitaxel and nedaplatin/cisplatin in the treatment of elderly patients with advanced esophageal cancer.Methods The clinical data of 62 patients with advanced esophageal squamous cell carcinoma who received first-line chemotherapy in Anhui Provincial Hospital Group from October 2018 to August 2020 were retrospectively analyzed. Thirty patients received camrelizumab (200 mg d1) + nab-paclitaxel (0.1 d1, d5) + nedaplatin (70 mg/m² d2) / cisplatin (30 mg d1 to 4), and 32 patients in group B received nab-paclitaxel + nedaplatin/cisplatin regimen. The short-term efficacy, tumor marker levels [carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) ], incidence of toxic and side effects, and prognosis and survival, were compared between the two groups.Results The objective remission rate of group A was higher than that of group B (P < 0.05). Compared with before treatment, the levels of CEA and SCC decreased after treatment (P < 0.05). After treatment, CEA and SCC in group A were lower than those in group B (P < 0.05). There was no significant difference in the total incidences of diarrhea, gastrointestinal reactions, bone marrow suppression, and liver and kidney function damage between group A and group B during treatment (P > 0.05). The survival rate of patients in group A was higher than that in group B (P < 0.05).Conclusion The first-line treatment of camrelizumab combined with albumin paclitaxel and nedaplatin/cisplatin in elderly patients with advanced esophageal cancer can improve the clinical efficacy, reduce the level of tumor markers, and prolong the short-term survival rate of patients with good safety.