Objective. To evaluate the safety and efficacy of chemoradiotherapy combined with anti-programmed death ligand 1 (PD-L1) immunotherapy in patients with limited-stage small cell lung cancer (LS-SCLC) Methods. We conducted a retrospective analysis of 42 patients treated at Xuzhou Cancer Hospital and Affiliated Hospital of Xuzhou Medical University from June 2020 to February 2022. Patients receiving CRT were included in the control group(n = 22), whereas patients receiving PD-L1 combined with CRT were enrolled in the study group(n = 20). The Progression free survival (PFS), adverse reactions (AEs), and short-time clinical effectiveness of the two groups were observed. Results . Compared with the control group, the disease-control rate (DCR) and objective response rate (ORR) in the study group were substantially higher than that of control group (95.00% vs 90.9%,90.00% vs 72.73%; p > 0.05). The serum of levels of Pro GRP, NSE and CYFRA21-1 in the two groups considerably lower after treatment (p < 0.05), and the serum levels of Pro GRP and NSE in the study group were significantly lower than those in the control group (p < 0.05). whereas CEA and CYFRA21-1 were not significantly changed (p > 0.05). Following therapy, CD3+, CD4+ and CD4+/CD8+ in both groups increased dramatically (p < 0.05), whereas CD8+ were not significantly changed, there was no statistical difference between the two groups (p > 0.05). The incidence of gastrointestinal, respiratory, blood and immune-related adverse events did not significantly differ between the two groups (p > 0.05). The median follow-up time was 14.2 months (study group) and 15.3 months (control group). Anti-PD-L1 immunotherapy significantly improved PFS (p < 0.05). The median PFS in the control group for the first-line treatment patients was 8.7months [95% CI,7.5–10.5 months], whereas for the study group median PFS was not reached. The mean PFS of study group substantially longer than of the control group (p < 0.05). Conclusion . our data support that anti-PD-L1 immunotherapy plus chemoradiotherapy has a good and safe and curative effect on LS-SCLC patients and it can be worth of clinical application.
Objective: To investigate the clinical efficacy of PD-L1 inhibitor combined with chemotherapy in the treatment of elderly extensive-stage small cell lung cancer and the changes of T lymphocyte subsets before and after treatment. Methods: Sixty-four elderly patients admitted to the Affiliated Hospital of Xuzhou Medical University from September 2020 to May 2022 who met the inclusion criteria for primary diagnosis of extensive-stage small cell lung cancer were selected, 34 patients in the control group and 30 patients in the observation group. All patients in the control group were given platinum-based etoposide regimen chemotherapy, while patients in the observation group were treated with dulvalizumab or atelelizumab combined with platinum-etoposide. The tumor markers, lymphocyte subsets, progression-free survival and depth of remission were compared between the two groups after 4 courses of treatment. Results: The CD3+, CD4+ and CD4+/CD8+ T lymphocyte ratios in the observation group were significantly higher than those in the control group, with statistically significant differences (P< 0.05) while there was no significant difference between the two CD8+ groups after treatment, (P> 0.05). Progression-free survival (7.5 months vs. 5.9 months, P = 0. 013), the depth of remission in the observation group was better than that in the control group. Conclusion: PD-L1 inhibitor combined with chemotherapy for distant metastatic small cell lung cancer effectively modulates T-lymphocyte subpopulation, improves the body's immune capacity, and achieves better survival benefit.
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