卡瑞利珠单抗联合白蛋白结合型紫杉醇、顺铂在晚期食管癌中的应用研究

Efficacy of camrelizumab combined with albumin-bound paclitaxel and cisplatin in advanced esophageal cancer

摘要:

目的 探讨卡瑞利珠单抗联合白蛋白结合型紫杉醇、顺铂在晚期食管癌中的应用效果。方法 选取2023年8月—2025年3月在南京鼓楼医院集团宿迁医院接受治疗的98例晚期食管癌患者，按随机数字表法分为对照组和观察组，各49例。对照组接受白蛋白结合型紫杉醇、顺铂化疗，观察组在对照组基础上联合应用卡瑞利珠单抗。21 d为一个周期，两组均治疗4个周期。比较两组客观缓解率（ORR）和疾病控制率（DCR）、免疫功能、肿瘤标志物水平、外泌体中程序性死亡受体1（PD-1）、程序性死亡配体1（PD-L1）水平、吞咽功能和生活质量、不良反应发生情况。结果 观察组ORR、DCR均高于对照组（P <0.05）；观察组治疗前后CD3^＋、CD4^＋、CD8^＋ T细胞的差值均小于对照组（P <0.05）；观察组治疗前后癌胚抗原、糖类抗原19-9、鳞状细胞癌抗原的差值均大于对照组（P <0.05）；观察组治疗前后PD-1、PD-L1的差值均大于对照组（P <0.05）；观察组治疗前后吞咽功能评定量表评分、食管癌生命质量测定量表评分的差值均大于对照组（P <0.05）；两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 卡瑞利珠单抗联合白蛋白结合型紫杉醇、顺铂方案可提高晚期食管癌患者ORR、DCR，改善患者免疫功能、吞咽功能与生活质量，同时未显著增加不良反应。

Abstract:

Objective To investigate the efficacy of camrelizumab combined with albumin-bound paclitaxel and cisplatin in advanced esophageal cancer.Methods A total of 98 patients with advanced esophageal cancer who received treatment at Nanjing Drum Tower Hospital Group Suqian Hospital from August 2023 to March 2025 were selected and divided into a control group and an observation group using a random number table, with 49 patients in each group. The control group received albumin-bound paclitaxel and cisplatin chemotherapy, while the observation group received camrelizumab in addition to the control group's regimen. Each treatment cycle lasted 21 days, and both groups received four cycles of treatment. The objective response rate (ORR), disease control rate (DCR), immune function, levels of tumor markers, programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1) levels in exosomes, swallowing function, quality of life, and incidence of adverse reactions were compared between the two groups.Results The ORR and DCR of the observation group were higher than those of the control group (P < 0.05). The differences in CD3⁺, CD4⁺, and CD8⁺ T-cell levels before and after treatment in the observation group were smaller than those in the control group (P < 0.05). The differences in CEA, CA199, and SCC levels before and after treatment in the observation group were greater than those in the control group (P < 0.05). The differences in PD-1 and PD-L1 levels before and after treatment in the observation group were greater than those in the control group (P < 0.05). The differences in SSA and QLICP-ES scores before and after treatment in the observation group were greater than those in the control group (P < 0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (P > 0.05).Conclusion The combination of camrelizumab with albumin-bound paclitaxel and cisplatin can improve the ORR and DCR of patients with advanced esophageal cancer, and enhance their immune function, swallowing function, and quality of life, without significantly increasing the incidence of adverse reactions.