标题：卡瑞利珠单抗联合白蛋白紫杉醇+奈达铂/顺铂治疗老年晚期食管癌的疗效及安全性研究

      作者：王亚楠 1，李文玉 2，赵红珂 1，寇卫政 1    王亚楠 1，李文玉 2，赵红珂 1，寇卫政 1新乡医学院第一附属医院肿瘤科 1、核磁共振科 2，河南 新乡 453100

      卷次： 2024年35卷3期

      【摘要】 目的 探讨卡瑞利珠单抗联合白蛋白紫杉醇+奈达铂/顺铂治疗老年晚期食管癌的疗效及安全性。方法 选择2019年1月至2022年1月新乡医学院第一附属医院收治的90例食管癌患者作为研究对象，根据随机数表法将患者分为观察组和对照组，每组45例。对照组患者给予白蛋白紫杉醇+奈达铂/顺铂治疗，观察组患者在对照组基础上联合卡瑞利珠单抗治疗，每21 d为一个治疗周期，所有患者均连续治疗4个周期。比较两组患者的治疗效果和化疗前后的肿瘤标志物指标[糖类抗原125 (CA125)、糖类抗原199 (CA199)、癌胚抗原(CEA)]；随访1年统计两组患者的生存率，并记录两组患者治疗期间的不良反应情况。结果 观察组患者的客观缓解率为66.67%，明显高于对照组的40.00%，差异有统计学意义(P<0.05)；化疗前，两组患者的肿瘤标志物比较差异均无统计学意义(P>0.05)，化疗后，两组患者的CA125、CA199、CEA水平均明显降低，且观察组分别为(43.29±4.10) U/mL、(49.18±3.72) U/mL、(19.28±2.19) U/mL，明显低于对照组的(48.29±5.41) U/mL、(53.10±3.99) U/mL、(24.29±2.90) U/mL，差异均有统计学意义(P<0.05)；观察组患者的 1年生存率和平均生存期分别为 86.67%，(341.11±63.50) d，明显高(长)于对照组的60.00%、(292.47±92.74) d，差异均有统计学意义(P<0.05)；治疗期间观察组患者的不良反应总发生率为11.11%，略低于对照组的13.33%，但差异无统计学意义(P>0.05)。结论 卡瑞利珠单抗联合白蛋白紫杉醇+奈达铂/顺铂治疗老年晚期食管癌的效果更显著，可降低患者血清肿瘤标志物水平，提高患者1年生存率，安全性良好，可在临床推广应用。
      【关键词】 老年；食管癌；卡瑞利珠单抗；白蛋白紫杉醇；奈达铂/顺铂；疗效；安全性
      【中图分类号】 R735.1 【文献标识码】 A 【文章编号】 1003—6350（2024）03—0310—04

Efficacy and safety of camrelizumab combined with albumin paclitaxel + nidaptin/cisplatin in the treatment ofadvanced esophageal cancer in elderly patients.
WANG Ya-nan 1, LI Wen-yu 2, ZHAO Hong-ke 1, KOU Wei-zheng 1.Department of Oncology 1, Department of Magnetic Resonance 2, the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100, Henan, CHINA
【Abstract】 Objective To investigate the efficacy and safety of camrelizumab combined with albumin paclitax-el+nedaplatin/cisplatin in the treatment of elderly patients with advanced esophageal cancer. Methods Ninety esopha-geal cancer patients admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2019 to January2022 were selected as the research subjects. According to the random number table method, the patients were divided in-to an observation group and a control group, with 45 cases in each group. Patients in the control group were treated withalbumin paclitaxel+nedaplatin/cisplatin, while patients in the observation group were additionally treated with calerizum-ab on the basis of the control group, with 21 days as one treatment cycle. All patients were treated continuously for fourcycles. The treatment efficacy and tumor marker indicators before and after chemotherapy between two groups of pa-tients [carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), carcinoembryonic antigen (CEA)] werecompared. The patients were followed up for 1 year, the survival rates of two groups of patients were calculated, and theadverse reactions during treatment in both groups were recorded. Results The objective response rate of the observa-tion group was 66.67%, which was significantly higher than 40.00% in the control group (P<0.05). After chemotherapy,the levels of CA125, CA199, and CEA in both groups of patients were significantly reduced, and the levels in the obser-vation group were (43.29±4.10) U/mL, (49.18±3.72) U/mL, and (19.28±2.19) U/mL, which were significantly lowerthan (48.29±5.41) U/mL, (53.10±3.99) U/mL, and (24.29±2.90) U/mL in the control group (P<0.05). The one-year sur-vival rate and average survival time of the observation group were 86.67% and (341.11±63.50) days, which were signifi-cantly higher or longer than 60.00% and (292.47±92.74) days in the control group (P<0.05). The incidence of adversereactions in the observation group was 11.11%, which was slightly lower than 13.33% in the control group (P>0.05).Conclusion The combination of carolizumab and albumin paclitaxel+nidaptin/cisplatin has a more significant effect onthe treatment of advanced esophageal cancer in the elderly, which can reduce the serum tumor marker levels of patients,improve their 1-year survival rate, and has good safety, and thus can be widely promoted and applied in clinical practice.
      【Key words】 Elderly; Esophageal cancer; Camrelizumab; Albumin paclitaxel; Nedaplatin/cisplatin; Efficacy;Safety