Abstract:Objective: To investigate the short-term efficacy, long-term efficacy, and safety of sintilimab combined with AP chemotherapy in the treatment of advanced lung adenocarcinoma with malignant pleural effusion. Methods: 124 cases of advanced lung adenocarcinoma with malignant pleural effusion patients were selected as the study subjects,and were divided into chemotherapy group (n=63) and sintilimab group (n=61)according to the central stochastic system assignment methods. The chemotherapy group received pemetrexed + cisplatin chemotherapy and the sintilimab group was combined with sintilimab on the basis of the control group. The treatment for 4 cycles was conducted to observe the short-term efficacy of pleural effusion, tumor marker level, KPS score, long-term survival and adverse reactions in the two groups. Results: After 4 cycles of treatment, the objective effusion efficiency and disease control rate of the sintilimab group was significantly better than that of the chemotherapy group, with statistically significant differences (P<0.05). After treatment, the levels of tumor markers significantly decreased and they were significantly lower in sintilimab group than those in the chemotherapy group. In terms of patients' quality of life score, the sintilimab group showed significant improvement compared with the chemotherapy group, with statistically significant difference (P<0.05). The median survival time in sintilimab group was better than that in the chemotherapy group, and the difference was statistically significant (P<0.05). Compared with the incidence of common clinical adverse reactions in the two groups, the incidence of bone marrow suppression and muscle pain in the sintilimab group was lower than that in the chemotherapy group, with statistically significant differences (P<0.05). Conclusion: Combined with sintilimab on the basis of AP chemotherapy, the short-term efficacy, tumor marker level, KPS score and long-term survival rate of pleural effusion were significantly improved ,and with less adverse reactions, worthy of clinical promotion
李小勤, 黄春梅, 罗娟, 李嵘. 信迪利单抗联合AP化疗治疗晚期肺腺癌合并恶性胸腔积液的临床研究[J]. 河北医学, 2021, 27(12): 2079-2084.
LI Xiaoqin, HUANG Chunmei, LUO Juan, et al. Effect of Sintilimab Combined with AP Chemotherapy in the Treatment of Advanced Lung Adenocarcinoma with Malignant Pleural Effusion. HeBei Med, 2021, 27(12): 2079-2084.
[1] Hyuna S,Jacques F,L S R,et al.Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.[J].CA:A Cancer Journal for Clinicians,2021,71(3):209~249. [2] 王帅,刘素艳,李艳艳,等.榄香烯联合奈达铂治疗恶性胸腹水临床观察[J].中华肿瘤防治杂志,2018,25(18):1328~1331. [3] 柯华,刘咏梅,陈维永,等.贝伐珠单抗联合化疗对肺腺癌患者恶性胸腔积液的疗效及安全性研究[J].中国临床保健杂志,2019,22(4):484~487. [4] A P,A B C.Current landscape of immunotherapy for the treatment of metastatic non-small-cell lung cancer.[J].Current oncology (Toronto,Ont.),2018,25(Suppl 1):s92~s102. [5] Yuankai S,Hang S,Yongping S,et al.Safety and activity of sintilimab in patients with relapsed or refractory classical Hodgkin lymphoma (ORIENT-1):a multicentre,single-arm,phase 2 trial.[J].The Lancet.Haematology,2019,6(1):e12~e19. [6] B R C,M D M,L D R,et al.Summary for clinicians:clinical practice guideline for management of malignant pleural effusions.[J].Annals of the American Thoracic Society,2019,16(1):17~21. [7] J M D,M P J,M R N.Malignant pleural effusions:management options.[J].Seminars in Respiratory and Critical Care Medicine,2018,39(6):704~712. [8] Carmichael J A,Mak D W,Brien M O.A review of recent advances in the treatment of elderly and poor performance NSCLC[J].Cancers,2018,10(7):236. [9] Kang D H,Chung C,Kim J O,et al.Pleural or pericardial metastasis:a significant factor affecting efficacy and adverse events in lung cancer patients treated with PD-1/PD-L1 inhibitors[J].Thoracic Cancer,2018,9(11):1500~1508. [10] C A K,J R G.Systemic therapy for locally advanced and metastatic non-small cell lung cancer:a review.[J].JAMA,2019,322(8):764~774. [11] 唐丹丹,何家富,曾宪升,等.肺癌致胸腔积液胸水CEA和CA125水平及临床价值[J].热带医学杂志,2019,19(11):1392~1395. [12] 段新春,崔永,龚民,等.手术前后血清CEA和CYFRA21-1水平的变化有助于预测非小细胞肺癌患者的预后[J].中国肺癌杂志,2015,18(6):358~364.