PD-1抑制剂联合诱导化疗治疗局部晚期喉癌和下咽癌的疗效与毒性
Efficacy and toxicity of PD-1 inhibitor combined with induction chemotherapy for locally advanced laryngeal and hypopharyngeal cancers.
作者信息
Zhao Tingting, Liu Wan, Yan Rong, Ma Yanjie, Wang Xudong, Wei Minghui
机构信息
Department of Head and Neck Oncology, Tianjin Medical University Cancer Institute & Hospital, Key Laboratory of Basic and Translational Medicine on Head & Neck Cancer, Tianjin, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer Tianjin 300060, China.
Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Shenzhen 518116, Guangdong, China.
出版信息
Am J Cancer Res. 2025 May 15;15(5):2193-2207. doi: 10.62347/HVRH6856. eCollection 2025.
OBJECTIVE
To evaluate the efficacy, toxicity, and voice rehabilitation outcomes of PD-1 inhibitors combined with induction chemotherapy (PCIC) compared to induction chemotherapy (IC) alone.
METHODS
A retrospective analysis was conducted on 250 patients with stage III/IVA squamous cell carcinoma of the larynx/hypopharynx treated between June 2021 and December 2023. After 1:1 propensity score matching, 216 patients (108 per group) were analyzed. Both groups received platinum-based induction chemotherapy, with the PCIC group receiving an additional PD-1 inhibitor, toripalimab. Efficacy was evaluated based on response rates and survival outcomes, while toxicity profiles and voice rehabilitation were assessed.
RESULTS
The PCIC group had significantly higher complete remission rates (81.48% vs. 65.74%; P = 0.021) and improved 1-year overall survival (62.96% vs. 49.07%; P = 0.040). The incidence of neutropenia and nausea was higher in the PCIC group (P < 0.05). Voice quality assessments showed worse objective vocal grade but better patient-perceived vocal quality in the PCIC group (both P < 0.05).
CONCLUSION
The combination of PD-1 inhibitors with induction chemotherapy improve remission rates and survival in patients with locally advanced laryngeal and hypopharyngeal cancers. However, increased toxicity and voice rehabilitation challenges highlight the need for comprehensive patient support during treatment.
目的
评估与单纯诱导化疗（IC）相比，程序性死亡受体1（PD-1）抑制剂联合诱导化疗（PCIC）的疗效、毒性及嗓音康复效果。
方法
对2021年6月至2023年12月期间接受治疗的250例Ⅲ/ⅣA期喉/下咽鳞状细胞癌患者进行回顾性分析。经过1:1倾向评分匹配后，分析了216例患者（每组108例）。两组均接受铂类诱导化疗，PCIC组额外接受PD-1抑制剂特瑞普利单抗。基于缓解率和生存结果评估疗效，同时评估毒性特征和嗓音康复情况。
结果
PCIC组的完全缓解率显著更高（81.48%对65.74%；P = 0.021），且1年总生存率有所提高（62.96%对49.07%；P = 0.040）。PCIC组中性粒细胞减少和恶心的发生率更高（P < 0.05）。嗓音质量评估显示，PCIC组的客观嗓音等级更差，但患者自我感觉的嗓音质量更好（均P < 0.05）。
结论
PD-1抑制剂与诱导化疗联合应用可提高局部晚期喉癌和下咽癌患者的缓解率及生存率。然而，毒性增加和嗓音康复挑战突出了治疗期间为患者提供全面支持的必要性。
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