实用医学杂志 ›› 2022, Vol. 38 ›› Issue (24): 3100-3105.doi: 10.3969/j.issn.1006⁃5725.2022.24.014

• 临床研究 • 上一篇    下一篇

PD-1抑制剂联合脑部放疗治疗驱动基因阴性非小细胞肺癌脑转移的疗效及安全性分析 

徐璐 黄栎有 王延花 温林春    

  1. 南京鼓楼医院集团宿迁医院(徐州医科大学附属宿迁医院)肿瘤科(江苏宿迁 223800)

  • 出版日期:2022-12-25 发布日期:2022-12-25
  • 通讯作者: 温林春 E⁃mail:sqwenlinchun@163.com
  • 基金资助:
    宿迁市科技社会发展项目(编号:S202018);徐州医科大学附属医院发展基金(编号:XYFY2021044);2021 年宿迁市指导性科技计划项目(编号:Z2021101)

Efficacy and safety ofPD ⁃ 1 inhibitor combined with brain radiotherapy for brain metastases in patients with pan⁃negative non⁃small cell lung cancer

XU Lu,HUANG Liyou,WANG Yanhua,WEN Linchun.   


  1. Depart⁃ ment of Oncology,Nanjing Drum Tower Hospital Group Suqian Hospital(the Affiliated Suqian Hospital of Xuzhou Medical University),Suqian 223800,China

  • Online:2022-12-25 Published:2022-12-25
  • Contact: WEN Linchun E⁃mail:sqwenlinchun@163.com

摘要:

目的 探讨 PD⁃1 抑制剂联合脑部放疗治疗驱动基因阴性非小细胞肺癌(NSCLC)脑转移患 者的疗效及安全性。方法 回顾性收集于 2016 年 8 月至 2021 年 8 月在南京鼓楼医院集团宿迁医院治疗 的 62 例驱动基因阴性 NSCLC 脑转移患者。比较单纯脑部放射治疗和 PD⁃1 抑制剂联合脑部放疗患者的 脑转移瘤局部控制率,颅内新发病灶的发生率,总生存期(OS)、无进展生存期(PFS),不良反应发生率。 结果 单纯放疗组与联合治疗组颅内新发病灶的发生率分别为 54.1%(20/37)和 28.0%(7/25)(= 0.042)。 联合治疗组的中位 PFS 比单纯放疗组延长 1.5 个月(= 0.005)。联合治疗组的中位 OS 比单纯放疗组延长 3.6 个月(= 0.016)。治疗方式是影响 PFS(= 0.004)和 OS(= 0.01)的独立危险因素。治疗期间两组 不良反应均可耐受。结论 驱动基因阴性的 NSCLC 脑转移患者采用脑部放疗联合 PD⁃1 抑制剂治疗,有 利于延长患者的PFS 及OS,不良反应可耐受。

关键词:

非小细胞肺癌; , 免疫治疗; , 放射治疗; , 免疫检查点抑制剂; , 脑转移

Abstract:

Objective To evaluate the efficacy and safety of PD⁃1 Inhibitor combined with brain radiotherapy for brain metastases in patients with pan negative non⁃small cell lung cancer(NSCLC). Methods The clinical data of 62 pan ⁃negative NSCLC patients with brain metastases treated at our hospital between August 2016 and August 2021 were retrospectively analyzed to compare the local control rate of brain metastases,incidence of new intracranial lesions,overall survival,progression ⁃ free survival and occurrence of adverse reactions between the group with radiation therapy alone and the group with radiation plus anti⁃PD⁃1 therapy. Results The incidence of new intracranial lesions in the former andlatter groupwas 54.1%(20/37)and 28.0%(7/25),respectively(P = 0.042). The median progression free survival(PFS)for the latter group was 1.5 months longer than the latter group (P = 0.005). The median overall survival(OS)of the group with the radiation plus anti ⁃ PD ⁃ 1 therapy was 3.6 months longer than the group with radiation therapy alone(P = 0.016). Treatment modality was an independent risk factor for both PFS(P = 0.004)and OS(P = 0.01). The adverse effects could be tolerated. Conclusion For pan⁃negative NSCLC patients with brain metastases,radiation plus anti⁃PD⁃1 therapy may prolong PFS and OS with the adverse reactions tolerable.

Key words:

non ?small cell lung cancer, immunotherapy, radiation therapy, immune checkpoint inhibitors, brain metastasis