放疗联合PD-1抑制剂及酪氨酸激酶抑制剂治疗MSS型结直肠癌肝转移疗效及安全性

doi:10.3969/j.issn.1006-5725.2024.09.019

Abstract

Abstract:

Objective To observe the efficacy and safety of radiotherapy combined with programmed death receptor?1 （PD?1） inhibitors and tyrosine kinase inhibitors （TKIs） for the treatment of microsatellite?stabilized （MSS）?type or mismatch?matched repair?normal （pMMR）?type colorectal cancer with liver metastases （CCLM）. Methods Case data of 25 patients with MSS?type CCLM admitted to Jiangsu Provincial Cancer Hospital from April 2021 to August 2023 were retrospectively analyzed. They were divided into observation group （n = 12） and control group （n = 13）. The observation group was given radiotherapy combined with PD?1 inhibitor and TKI treatment， and the control group was given TKI monotherapy. The baseline data， treatment effect， progression?free survival， and treatment?related adverse reactions of patients in the two groups were compared. Results The difference in baseline data between the two groups was not statistically significant （P > 0.05）， the disease control rate （DCR） of the observation group was higher than that of the control group （P < 0.05）， the progression?free survival （PFS） of the patients in the observation group was longer than that of the control group， but the difference was not statistically significant （P > 0.05）， and the difference in the incidence of treatment?related adverse events （TRAE） between the two groups was not statistically significant （P > 0.05）. Conclusion The treatment regimen of radiotherapy combined with PD?1 inhibitors and TKI drugs improved clinical efficacy and did not increase the incidence of adverse events when compared with TKI alone， which is a treatment regimen worthy of further validation.

Key words: colorectal cancer, radiotherapy, immune checkpoint inhibitor, tyrosine kinase inhibitors, liver metastases

CLC Number:

R735.3

Yuxuan DING,Lining GUO,Jiayi SHEN,Lijun. WANG. Safety and efficacy of radiotherapy and PD⁃1/PD⁃L1 inhibitor + TKI for MSS/pMMR colorectal cancer with liver metastases[J]. The Journal of Practical Medicine, 2024, 40(9): 1293-1297.

Figures/Tables 5

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References 23

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项目	观察组（n = 12）	对照组（n = 13）	χ²值	P值
性别			2.493	0.114
男	10（83.33）	7（53.85）
女	2（16.67）	6（46.15）
年龄			0.427	0.513
< 60岁	8（66.67）	7（53.85）
≥ 60岁	4（33.33）	6（45.15）
病灶			0.294	0.588
左	11（91.67）	11（84.62）
右	1（8.33）	2（15.38）
RAS突变情况			1.987	0.866
野生	4（33.33）	6（46.15）
突变	6（50.00）	5（38.26）
未测	2（16.67）	2（15.38）
其他转移部位
肺	7（58.33）	11（84.61）	2.138	0.144
淋巴结	9（75.00）	8（61.53）	0.520	0.471
骨	3（25.00）	2（15.38）	0.361	0.548
其他	6（50.00）	7（53.85）	0.037	0.848
TKI使用情况			1.470	0.225
瑞戈非尼	2（16.67）	5（38.26）
呋喹替尼	10（83.33）	8（61.53）

组别	例数	CR	PR	CD	PD	治疗有效率	疾病控制率
P值	-	-	-	-	-	0.593	0.047
观察组	12	0	2	6	4	2（16.67）	8（66.67）
对照组	13	0	1	2	10	1（7.69）	3（23.08）

项目	观察组（n = 12）	对照组（n = 13）	χ²值	P值
白细胞减少	4（33.33）	5（38.46）	0.071	0.79
中性粒细胞减少	3（25.00）	3（23.08）	0.013	0.910
血小板减少	4（33.33）	4（30.77）	0.019	0.891
恶心呕吐	3（25.00）	5（38.46）	0.520	0.471
腹泻	2（16.67）	1（7.69）	0.476	0.490
肝功能异常	6（50.00）	8（61.54）	0.337	0.561

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Safety and efficacy of radiotherapy and PD⁃1/PD⁃L1 inhibitor + TKI for MSS/pMMR colorectal cancer with liver metastases

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