Clinical Efficacy of Anti-programmed Death Ligand 1 Immunotherapy Combined with Chemoradiotherapy in the Treatment of Limited-stage Small Cell Lung Cancer and Its Effect on Serum Tumor Markers and T Lymphocyte Subsets

Abstract

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.