卡瑞利珠单抗联合同步放化疗在驱动基因阴性非鳞NSCLC脑转移患者中的近期疗效及安全性观察

目的 探讨卡瑞利珠单抗联合同步放化疗在驱动基因阴性非鳞非小细胞肺癌（NSCLC）脑转移患者中的近期疗效以及不良反应。方法 选取2019年1月—2019年12月在我院经病理检查确诊的非鳞NSCLC脑转移患者64例，随机数字表法分为对照组和观察组，每组32例。所有患者经高通量测序法（HTS）检测示驱动基因阴性。对照组给予颅内转移瘤放疗联合吉西他滨+卡铂方案化疗，观察组在对照组的基础上同步卡瑞利珠单抗免疫治疗。观察两组患者治疗前后健康调查简表（SF-36）评分、近期疗效及不良反应。结果 治疗后，观察组患者客观有效率（ORR）、疾病控制率（DCR）均显著高于对照组（P<0.05）；SF-36评分显著高于对照组（P<0.05）；反应性毛细血管增生症、贫血、乏力、甲状腺功能减低症、蛋白尿、免疫相关性肺炎、免疫相关性腹泻、免疫相关性肝炎、免疫相关性肾炎和免疫相关性心肌炎的发生率均显著高于对照组（P<0.05）。结论 卡瑞利珠单抗联合同步放化疗在驱动基因阴性非鳞NSCLC脑转移患者中的近期疗效可靠，不良反应可耐受，为此类患者的治疗提供了新的思路。

The short-term efficacy and safety of camrelizumab combined with concurrent radiochemotherapy in non-squamous NSCLC patients with driver gene-negative and brain metastases

Objective To explore the short-term efficacy of camrelizumab combined with concurrent radiochemotherapy in patients with driver gene-negative non-squamous non-small cell lung cancer (NSCLC) and brain metastases, and observe the adverse drug reactions.Methods Sixty-four patients with non-squamous NSCLC and brain metastases confirmed by pathology between January 2019 and December 2019 in our hospital were selected. All of them had driver gene negative after high-throughput sequencing (HTS) test. They were randomly divided into control group and observation group, 32 patients in each group. The control group was given intracranial metastasis radiotherapy combined with gemcitabine plus carboplatin chemotherapy. The observation group was synchronized with camrelizumab immunotherapy on the basis of treatment of the control group. Observe the scores of the MOS item short from health survey (SF-36) before and after treatment, and compare the short-term efficacy and adverse drug reactions of patients after treatment between the two groups.Results After treatment, the observation group had higher ORR and DCR than the control group (P<0.05), and also higher SF-36 scores than the control group (P<0.05). The incidence of adverse reactions in terms of reactive capillary hyperplasia, anemia, fatigue, hypothyroidism, proteinuria, immune-related pneumonia, immune-related diarrhea, immune-related hepatitis, immune-related nephritis, and immune-related myocarditis were higher in observation group than that in control group (P<0.05).Conclusion Camrelizumab combined with concurrent radiochemotherapy in driver gene-negative non-squamous NSCLC brain metastasis patients has reliable short-term efficacy and tolerable adverse reactions.