目的 探究納武利尤單抗注射液聯(lián)合鹽酸安羅替尼膠囊治療晚期非小細(xì)胞肺癌的臨床療效。方法 選取2019年1月—2020年1月臨汾市中心醫(yī)院收治的60例晚期非小細(xì)胞肺癌患者為研究對(duì)象，根據(jù)患者治療方法不同分為對(duì)照組（29例）和治療組（31例）。對(duì)照組患者早餐前口服鹽酸安羅替尼膠囊，12 mg/次，1次/d，連續(xù)服藥2周，停藥1周。治療組患者在對(duì)照組治療的基礎(chǔ)上靜脈輸注納武利尤單抗注射液，3 mg/kg，1次/2周，評(píng)估患者耐受性和療效。兩組患者均持續(xù)治療9周。觀察兩組近期臨床療效，比較治療前后兩組生活質(zhì)量、T淋巴細(xì)胞亞群、血管內(nèi)皮細(xì)胞生長(zhǎng)因子（VEGF）水平變化和生存情況。結(jié)果 治療后，治療組客觀緩解率（ORR）、疾病控制率（DCR）均較高于對(duì)照組，組間比較差異具有顯著差異（P<0.05）。治療后，兩組患者CD3⁺、CD4⁺、CD4⁺/CD8⁺均明顯升高，CD8⁺、VEGF均明顯降低（P<0.05）；治療組CD3⁺、CD4⁺、CD4⁺/CD8⁺均明顯高于對(duì)照組，CD8⁺、VEGF均明顯低于對(duì)照組（P<0.05）。治療后2、4、6個(gè)月，兩組EORTC QLQ-C30總評(píng)分均明顯降低（P<0.05），且治療組EORTC QLQ-C30總評(píng)分明顯低于同期對(duì)照組（P<0.05）。治療后，治療組中位無(wú)進(jìn)展生存期（PFS）、總生存期（OS）較對(duì)照組明顯增長(zhǎng)（P<0.05）。結(jié)論 納武利尤單抗注射液聯(lián)合鹽酸安羅替尼膠囊治療晚期非小細(xì)胞肺癌具有較好的臨床療效，可改善患者的生活質(zhì)量，調(diào)節(jié)患者免疫功能，降低VEGF水平，且不增加不良反應(yīng)。

Objective To investigate the efficacy of Nivolumab Injection combined with Anlotinib Hydrochloride Capsules in treatment of advanced non-small cell lung cancer. Methods Patients (60 cases) with advanced non-small cell lung cancer in Linfen Central Hospital from January 2019 to January 2020 were divided into the control group (29 cases) and the treatment group (31 cases) according to different treatments. Patients in the control group were po administered with Anlotinib Hydrochloride Capsules before breakfast, 12 mg/time, once daily, the drug was taken continuously for 2 weeks and stopped for 1 week. Patients in the treatment group were iv administered with Nivolumab injection on the basis of the control group, 3 mg/kg, once every 2 weeks, and tolerance and efficacy were assessed. Both groups were treated continuously for 9 weeks. After treatment, the clinical efficacies were evaluated, and the quality of life, the T lymphocyte subsets, VEGF levels, and survival status in two groups were compared. Results After treatment, the objective remission rate (ORR) and disease control rate (DCR) in the treatment group were higher than those in the control group, and there was significant difference between the groups (P < 0.05). After treatment, CD3⁺, CD4⁺, CD₄⁺/CD8⁺ in the two groups were significantly higher than those before treatment, but CD8⁺ and VEGF were significantly lower than those before treatment (P < 0.05). CD3⁺, CD4⁺, CD4⁺/CD8⁺ in the treatment group were significantly higher than those in the control group, but CD8⁺ and VEGF were significantly lower than those in the control group (P < 0.05). At 2, 4, and 6 months after treatment, EORTC QLQ-C30 total scores in two groups were significantly lower than that before treatment (P < 0.05), and EORTC QLQ-C30 total scores in the treatment group were significantly lower than that in the control group at the same time (P < 0.05). After treatment, the median progression free survival (PFS) and overall survival (OS) in the treatment group were significantly higher than those in the control group (P < 0.05). Conclusion Nivolumab Injection combined with Anlotinib Hydrochloride Capsules has clinical curative in treatment of advanced non-small cell lung cancer, can improve the quality of life of patients, regulate the immune function of patients, reduce the level of VEGF, and do not increase the incidence of adverse reactions.

R979.1

臨汾市科技重點(diǎn)研發(fā)計(jì)劃（2135）