收稿日期: 2024-04-29
网络出版日期: 2024-12-23
基金资助
山东省医学会临床科研资金-齐鲁专项(YXH2022ZX02205)
Efficacy and safety analysis of pabolizumab plus low⁃dose apatinib combined chemotherapy in elderly patients with esophageal cancer
Received date: 2024-04-29
Online published: 2024-12-23
目的 分析帕博利珠单抗加小剂量阿帕替尼联合化疗应用于老年食管癌中的有效性及安全性。 方法 选择胜利油田中心医院2020年5月至2022年7月收治的188例老年食管癌患者，以随机数字表法分为研究组（n = 94）及对照组（n = 94）。对照组接受帕博利珠单抗联合FP化疗方案治疗，研究组接受小剂量阿帕替尼联合帕博利珠单抗及FP化疗方案治疗。对比两组临床疗效、肿瘤标志物、磷脂酰肌醇3激酶（PI3K）/苏氨酸蛋白激酶（Akt）信号蛋白通路、免疫功能、不良反应及生存情况。 结果 研究组客观缓解率高于对照组（P < 0.05）；治疗后，两组鳞状细胞癌抗原（SCC）、癌胚抗原（CEA）、PI3K、Akt、CD8+均降低（P < 0.05），且研究组更低（P < 0.05）。治疗后，两组CD3+、CD4+均升高（P < 0.05），且研究组更高（P < 0.05）。两组不良反应总发生率对比差异无统计学意义（P > 0.05）；随访1年，研究组存活率高于对照组（P < 0.05）。 结论 帕博利珠单抗加小剂量阿帕替尼联合治疗老年食管癌效果确切，可能通过降低PI3K/Akt信号蛋白通路活性抑制肿瘤进展，且可提高近期生存率。
张婷婷 , 刘克 , 陈丹 , 闫炳文 , 赵培娟 , 王宁 . 帕博利珠单抗加小剂量阿帕替尼联合治疗老年食管癌的有效性及安全性[J]. 实用医学杂志, 2024 , 40(24) : 3534 -3538 . DOI: 10.3969/j.issn.1006-5725.2024.24.016
Objective To evaluate the efficacy and safety of pabolizumab plus low-dose apatinib combined chemotherapy in elderly patients with esophageal cancer. Methods A total of 188 elderly patients with esophageal cancer admitted to Shengli Oilfield Central Hospital from May 2020 to July 2022 were selected and divided into study group （n = 94） and control group （n = 94） by random number table method. The control group received pabolizumab combined with FP chemotherapy regimen， and the study group received low-dose Apatinib combined with Pabolizumab and FP chemotherapy regimen. Clinical efficacy， tumor markers， phosphatidylinositol 3 kinase （PI3K）/threonine protein kinase （Akt） signaling protein pathway， immune function， adverse reactions and survival were compared between the two groups. Results The objective remission rate of the study group was higher than control group （P < 0.05）. After treatment， squamous cell carcinoma antigen （SCC）， carcinoembryonic antigen （CEA）， PI3K， Akt and CD8+ were all decreased in the two groups （P < 0.05）， and those in study group were lower （P < 0.05）. After treatment， CD3+ and CD4+ were increased in both groups （P < 0.05）， and higher in study group （P < 0.05）. There was no difference in the total incidence of adverse reactions between the two groups （P > 0.05）. The survival rate of the study group was higher than control group （P < 0.05）. Conclusion Pabolizumab plus low-dose apatinib combined with chemotherapy is effective in the treatment of elderly esophageal cancer， which may inhibit tumor progression by reducing the activity of PI3K/Akt signaling protein pathway and improve the short-term survival rate.
Key words： pabolizumab; apatinib; chemotherapy; esophageal cancer; old age; security; effectiveness
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