化疗联合抗PD1免疫检查点抑制剂在复发或转移性鼻咽癌中的治疗效果及其安全性评价

目的分析抗PD1免疫检查点抑制剂联合或不联合化疗对复发或转移性鼻咽癌的疗效和安全性。方法选择复发或转移性鼻咽癌患者67例为研究对象。根据患者接受治疗的差异分为两组,其中对照组41例患者单独使用抗PD1检查点抑制剂治疗,研究组26例患者实施抗PD1检查点抑制剂联合化疗。对比两组患者的治疗效果,包括客观有效率(ORR)、死亡率、无进展生存率(PFS)和总生存率(OS);统计两组患者治疗期间出现的不良反应发生情况。结果研究组患者的ORR高于对照组,而死亡率低于对照组,差异具有统计学意义(P<0.05)。研究组2例死亡,中位PFS为11个月(95%CI,4.120~17.880个月);对照组12例死亡,中位PFS为3个月(95%CI,2.276~3.724个月)。单变量分析表明,对照组患者1年OS和PFS明显高于研究组,差异具有统计学意义(P<0.05)。对照组患者发生血小板减少、中性粒细胞减少、贫血、厌食症、周围神经病变事件均低于研究组,差异具有统计学意义(P<0.05);而两组患者的肝功能、肾功能不全、皮疹、瘙痒、带状疱疹、肌痛、高血糖、肺炎、腹泻以及蛋白尿发生率比较,差异不具有统计学意义(P>0.05)。结论抗PD1检查点抑制剂中加入化疗可显著改善复发或转移性鼻咽癌患者的PFS和OS,值得临床进一步研究。

Efficacy and Safety of Chemotherapy Combined with Anti- PD1 Immune Checkpoint Inhibitors in Recurrent or Metastatic Nasopharyngeal Carcinoma

Objective To analyze the efficacy and safety of anti-pd1 immune checkpoint inhibitors combined with or without chemotherapy in the treatment of recurrent or metastatic nasopharyngeal carcinoma.Methods 67 patients with recurrent or metastatic nasopharyngeal carcinoma were selected as the research objects.According to the difference of treatment, the patients were divided into 2 groups.41 patients in the control group were treated with anti PD1 checkpoint inhibitor alone, and 26 patients in the study group were treated with anti PD1 checkpoint inhibitor combined with chemotherapy.The treatment effects of the 2 groups were compared, including objective response rate(ORR),mortality rate, progression free survival rate(PFS)and overall survival rate(OS);the occurrence of adverse reactions during the treatment of the 2 groups were counted.Results The ORR of the study group was higher than that of the control group, while the mortality was lower than that of the control group, the difference was statistically significant(P<0.05).The median PFS was 11 months(95%CI,4.120-17.880 months)in the study group and 3 months(95%CI,2.276-3.724 months)in the control group.Univariate analysis showed that the 1-year OS and PFS of the control group were significantly higher than those of the study group, and the difference was statistically significant(P<0.05).The incidence of thrombocytopenia, neutropenia, anemia, anorexia, peripheral neuropathy events in the control group were lower than those in the study group, the difference was statistically significant(P<0.05);the incidence of liver function, renal insufficiency, rash, pruritus, herpes zoster, muscle pain, hyperglycemia, pneumonia, diarrhea and proteinuria in the 2 groups were not statistically significant(P>0.05).Conclusion Anti PD1 checkpoint inhibitor combined with chemotherapy can significantly improve PFS and OS in patients with recurrent or metastatic nasopharyngeal carcinoma, which is worthy of further clinical study.