卡瑞利珠单抗联合卡培他滨用于一线治疗复发转移鼻咽癌患者维持治疗疗效及对患者免疫功能的影响

摘要 目的：探讨卡瑞利珠单抗联合卡培他滨用于一线治疗复发转移鼻咽癌（NPC）患者维持治疗的疗效及对患者免疫功能的影响。方法：选取2020年1月至2022年1月钦州市第一人民医院收治的80例复发转移NPC患者，按照随机数字表法分为对照组和观察组，每组各40例。两组均接受吉西他滨联合顺铂化疗，对照组化疗后接受卡瑞利珠单抗单药维持治疗至1年，观察组化疗后接受卡瑞利珠单抗联合卡培他滨维持治疗至1年。比较两组疗效，不良反应，治疗前后B淋巴细胞亚群和自然杀伤（NK）细胞所占百分比的差异。结果：观察组客观缓解率（ORR）、疾病控制率（DCR）高于对照组（P＜0.05）。两组治疗后外周血CD5⁺B细胞、CD5⁺CD19⁺ B细胞、CD3^-CD56⁺NK细胞占比降低（P＜0.05），但观察组治疗后外周血CD5⁺B细胞、CD5⁺CD19⁺ B细胞、CD3^-CD56⁺NK细胞占比高于对照组（P＜0.05）。两组Ⅲ度以上不良反应发生率比较差异无统计学意义（P＞0.05）。结论：卡瑞利珠单抗联合卡培他滨一线维持治疗复发转移NPC可提高临床疗效，减轻对细胞免疫功能的影响，且安全可靠。

Effect of Carelizumab Combined with Capecitabine on Maintenance Therapy Efficacy and Immune Function in First-Line Treatment of Patients with Recurrent Metastatic Nasopharyngeal Carcinoma

ABSTRACT Objective: To investigate the efficacy of carelizumab combined with capecitabine for maintenance therapy in first-line treatment of patients with recurrent metastatic nasopharyngeal carcinoma(NPC), and its impact on immune function of patients. Methods: 80 patients with recurrent metastasis of NPC who were admitted to Qinzhou First People''s Hospital from January 2020 to January 2022 were selected, the recurrent and metastatic NPC patients were divided into the control group and the observation group according to the random number table method, each group has 40 cases. Both groups received gemcitabine combined with cisplatin chemotherapy, the control group received carelizumab monotherapy maintenance treatment for 1 year after chemotherapy, and the observation group received carelizumab combined with capecitabine maintenance treatment for 1 year after chemotherapy. Differences in efficacy, adverse reactions, and percentage of B lymphocyte subsets and natural killer cells (NK) before and after treatment were compared between the two groups. Results: The objective remission rate (ORR) and disease control rate (DCR) in observation group were higher than those in control group(P<0.05). The percentages of CD5⁺B cells, CD5⁺CD19⁺B cells and CD3^-CD56⁺NK cells in peripheral blood after treatment was decreased between the two groups(P<0.05), but the percentages of CD5⁺B cells, CD5⁺CD19⁺ B cells and CD3^-CD56⁺NK cells in peripheral blood of the observation group were higher than those of the control group after treatment(P<0.05). There was no significant difference in the incidence of adverse reactions above grade III between the two groups(P>0.05). Conclusion: Carelizumab combined with capecitabine in first-line maintenance treatment of recurrent and metastatic NPC could improve clinical efficacy, reduce the impact on cellular immune function, and it was safe and reliable.