Abstract:

Objective To investigate the impact of sintilimab combined with TP chemotherapy regimen on immune function and prognostic survival in patients with advanced esophageal cancer. Methods A total of 82 patients with advanced esophageal cancer who received treatment in the hospital from January 2022 to October 2023 were enrolled. They were divided into two groups with 41 cases in each group using the random number table method. The control group was given the TP chemotherapy regimen， while the observation group was treated with sintilimab in addition to the TP chemotherapy regimen used in the control group. The treatment cycle was 21 days， and both groups received 4 cycles of treatment. After that， the observation group received sintilimab monotherapy for maintenance treatment for at least 1 year. The disease control rate （DCR） and objective response rate （ORR） of the patients were recorded. The immune function， levels of inflammatory factors and tumor markers before and after treatment were compared between the two groups. The swallowing function and quality of life of the patients before and after treatment were evaluated using the Swallowing Safety Assessment （SSA） and the Quality of Life Instruments for Cancer Patients - Esophageal Cancer （QLICP-ES）. The occurrence of adverse reactions was also recorded. After the start of treatment， the patients were followed up for 18 months， and the overall survival （OS） and survival rate were recorded. Results In the observation group， the partial remission rate and disease control rate were 53.66% and 87.80% respectively， both higher than those in the control group. After treatment， the levels of CD3⁺ and CD4⁺ in the observation group were （50.48 ± 5.61）% and （37.96 ± 4.69）% respectively， which were higher than （44.73 ± 5.12）% and （33.15 ± 4.21）% in the control group. The immune function of the observation group was improved compared with the control group， while the levels of inflammatory factors and tumor markers were lower than those in the control group. The swallowing function and quality of life were significantly improved compared with the control group （P < 0.05）.The 18-month follow-up results showed that the median overall survival （OS） in the observation group was 16 （9， 17） months， and that in the control group was 9 （7， 14） months. The OS in the observation group was longer than that in the control group （χ2 = 13.394， P < 0.001）. The 18months survival rates in the observation group and the control group were 60.98% （25/41） and 36.59% （15/41） respectively， with the observation group being higher than the control group （χ2 = 4.881， P = 0.027）. Conclusion The sintilimab combined with TP chemotherapy regimen is beneficial for improving immune function and enhancing the survival status of patients with advanced esophageal cancer.

Key words: sintilimab, TP chemotherapy regimen, advanced esophageal cancer, immune function, quality of life, prognosis