标题：氩氦刀冷冻消融联合PD1抑制剂+化疗治疗Ⅲb~Ⅳ期非小细胞肺癌的疗效评价

      作者：娄小飞 1，杜可朴 2，王猛 2，李亚丹 2，高飞 2，高梦宇 2，杜雅冰 3    郑州大学第一附属医院药学部 1、放射科 2、脑瘤内科 3，河南 郑州 450052

      卷次： 2023年34卷16期

      【摘要】 目的 评估氩氦刀冷冻消融联合抗程序性死亡蛋白1 (PD1)抑制剂+化疗治疗Ⅲb~Ⅳ期非小细胞肺癌(NSCLC)的临床疗效。方法 回顾性收集2017年5月至2020年5月郑州大学第一附属医院收治的54例经病理明确诊断不可手术切除的Ⅲb~Ⅳ期NSCLC肺癌患者的临床资料，根据治疗方法不同分为氩氦刀组 29例和标准治疗组 25例。化疗 4个周期(3周为一个化疗周期)后，比较两组患者的近期客观缓解率(ORR)、无进展生存期(PFS)和无进展生存率。结果 化疗 4个周期后，氩氦刀组患者的ORR为 75.86%，略高于标准治疗组的 60.00%，但差异无统计学意义(P>0.05)；随访3年，氩氦刀组患者的中位PFS为13.61个月，明显长于标准治疗组的9.72个月，差异具有统计学意义(P<0.05)；氩氦刀组患者 1年、2 年、3年无进展生存率分别为 82.76%、62.07%、13.79%，略高于标准治疗组的 76.00%、56.00%、8.00%，但差异均无统计学意义(P>0.05)。结论 氩氦刀消融联合PD1抑制剂+化疗用于治疗Ⅲb-Ⅳ期非小细胞肺癌，可在一定程度上提高患者的近期疗效和远期疗效，进一步提升患者的无进展生存期。
      【关键词】 非小细胞肺癌；冷冻消融；抗程序性死亡蛋白1；客观缓解率；中位生存期
      【中图分类号】 R734.2 【文献标识码】 A 【文章编号】 1003—6350（2023）16—2318—05

Clinical efficacy of argon-helium cryoablation combined with PD1 inhibitor + chemotherapy in the treatment ofstage Ⅲb-Ⅳ non-small cell lung cancer.
LOU Xiao-fei 1, DU Ke-pu 2, WANG Meng 2, LI Ya-dan 2, GAO Fei 2, GAOMeng-yu 2, DU Ya-bing 3. Department of Pharmacy 1, Department of Oncology 2, Department of Radiology 3, the FirstAffiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, CHINA
【Abstract】 Objective To evaluate the clinical efficacy of argon-helium cryoablation combined with anti-pro-grammed death protein 1 (PD1) inhibitor and chemotherapy in the treatment of stage Ⅲb~Ⅳ non-small cell lung can-cer (NSCLC). Methods From May 2017 to May 2020, the data of 54 patients with stage Ⅲb~ⅣNSCLC who wereconfirmed by pathology as inoperable were retrospectively collected in the First Affiliated Hospital of Zhengzhou Uni-versity. According to different treatment methods, they were divided into argon-helium knife group (29 cases) andstandard treatment group (25 cases). After 4 cycles of chemotherapy (3 weeks as a chemotherapy cycle), short-termobjective response rate (ORR), progression-free survival (PFS), and progression-free survival rate were compared be-tween the two groups. Results After 4 cycles of chemotherapy, the ORR of the argon-helium knife group was75.86%, which was slightly higher than 60.0% of the standard treatment group (P>0.05). After 3 years of follow-up,the PFS was 13.61 months in the argon-helium knife group, which was significantly longer than 9.72 months in the stan-dard treatment group (P<0.05). The 1-year, 2-year, and 3-year progression-free survival rates in the argon-helium knifegroup were 82.76%, 62.07%, and 13.79%, respectively, which were slightly higher than 76.00%, 56.00%, and 8.00% inthe standard treatment group (P>0.05). Conclusion Argon-helium ablation combined with PD1 inhibitor and chemo-therapy in the treatment of stage Ⅲb~Ⅳ non-small cell lung cancer can improve the short-term and long-term efficacy ofpatients to a certain extent, and further improve the progression-free survival of patients.
      【Key words】 Non-small cell lung cancer; Cryoablation; Anti-programmed death protein 1; Objective responserate; Median survival