三维后装腔内放疗、含铂单药化疗联合替雷利珠单抗治疗局部晚期宫颈癌的疗效研究

Efficacy of the combination of three-dimensional brachytherapy, platinum-based monochemotherapy, and tislelizumab in the treatment of locally advanced cervical cancer

摘要:

目的 探讨三维后装腔内放疗、含铂单药化疗联合替雷利珠单抗治疗局部晚期宫颈癌的临床疗效。方法 选取2021年1月—2022年1月中国人民解放军火箭军特色医学中心收治的102例局部晚期宫颈癌患者，采用随机数字表法，分为对照组和观察组，各51例。对照组接受三维后装腔内放疗和含铂单药化疗，观察组在对照组基础上联合替雷利珠单抗，均治疗6周。比较两组的临床疗效，以及治疗前后的肿瘤体积、免疫功能（CD3^＋、CD4^＋、CD8^＋）、肿瘤标志物水平［糖链抗原125（CA125）、鳞状细胞抗原（SCCA）、甲胎蛋白（AFP）］，记录不良反应。患者均随访2年，比较两组总生存期（OS）和生存率。结果 观察组总有效率高于对照组（P <0.05）。观察组治疗前后CD3^＋、CD4^＋、CD8^＋的差值均小于对照组（P <0.05），CA125、SCCA、AFP的差值均大于对照组（P <0.05）。对照组与观察组不良反应总发生率比较，差异无统计学意义（P >0.05）。随访2年，观察组和对照组OS分别为22.35（21.34，23.36）和19.57（18.02，21.11）个月，观察组和对照组生存率分别为76.47%（39/51）和54.90%（28/51）。观察组的生存曲线优于对照组（P <0.05）。结论 三维后装腔内放疗、含铂单药化疗联合替雷利珠单抗可提高局部晚期宫颈癌患者的临床疗效，延长生存期。

Abstract:

Objective To investigate the clinical efficacy of combination of three-dimensional brachytherapy, platinum-based monochemotherapy, and tislelizumab in managing locally advanced cervical cancer.Methods A total of 102 patients with locally advanced cervical cancer, treated at our hospital from January 2021 to January 2022, were enrolled in this study. They were randomly assigned into the control group (n = 51) and the observation group (n = 51) using a random number table method. The control group received three-dimensional brachytherapy combined with platinum-based monochemotherapy, while the observation group additionally received tislelizumab alongside the treatment in the control group. Both groups were treated for 6 weeks. The clinical efficacy and tumor volume, immune function (CD3⁺, CD4⁺, CD8⁺), and tumor marker levels [CA125 (carbohydrate antigen 125), SCCA (squamous cell carcinoma antigen), AFP (alpha-fetoprotein) ] before and after treatment were compared between the two groups. The adverse reactions were also recorded. All patients were followed up for 2 years to compare the overall survival (OS) and survival rates between the two groups.Results The overall effective rate in the observation group was higher than that in the control group (P < 0.05). The differences in CD3⁺, CD4⁺, and CD8⁺ levels before and after treatment were all smaller in the observation group than in the control group (P < 0.05), while the differences in CA125, SCCA, and AFP levels were all greater in the observation group than in the control group (P < 0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the observation group and the control group (P > 0.05). After a 2-year follow-up, the OS of the observation group and that of the control group were 22.35 (21.34, 23.36) and 19.57 (18.02, 21.11) months, respectively. The survival rates of the observation group and the control group were 76.47% (39/51) and 54.90% (28/51), respectively. The survival curve of the observation group was better than that of the control group (P < 0.05).Conclusion The combination of three-dimensional brachytherapy, platinum-based monochemotherapy, and tislelizumab can improve clinical efficacy and extend survival in patients with locally advanced cervical cancer.