地舒单抗联合免疫检查点抑制剂治疗实体瘤骨转移临床疗效及安全性

摘要 目的：探究地舒单抗联合免疫检查点抑制剂治疗实体瘤骨转移临床疗效及安全性。方法：选择2020年7月~2022年11月南通市肿瘤医院收治的60例实体瘤骨转移患者为本次研究对象，分为两组：观察组，n=18，对照组，n=42。对照组开展伊班膦酸+替雷利珠单抗治疗，观察组开展替雷利珠单抗+地舒单抗治疗。比较治疗效果、骨密度水平、骨相关事件、相关指标及安全性。结果：观察组治疗控制率为82.86 %，对照组治疗控制率为54.76 %，观察组更高（P＜0.05）；治疗前，观察组及对照组的右足SOS变化比较无差异（P＞0.05），治疗后，与治疗前相比，观察组及对照组均升高，且观察组更高（P＜0.05）；观察组骨相关事件发生率为22.22 %，对照组为50.00 %，观察组发生率更低（P＜0.05）；治疗前，匹兹堡睡眠质量指数（PSQI）、焦虑及抑郁自评表（SAS）、（SDS）、日常生活能力评价表（ADL）评分，观察组及对照组比较无差异（P＞0.05），治疗后，与治疗前比较，观察组及对照组各指标水平均降低，且观察组更低（P＜0.05）；观察组不良反应率为44.44 %，对照组不良反应率为52.38 %，观察组及对照组比较（P＞0.05）。结论：地舒单抗联合免疫检查点抑制剂治疗可有效提升实体瘤骨转移的治疗效果，提升骨密度，降低骨不良事件风险，改善患者心理及生理指标，促进日常生活能力的有效提升，且安全性较高。

Clinical Efficacy and Safety of Denosumab Combined with Immune Checkpoint Inhibitor in the Treatment of Solid Tumor with Bone Metastases

ABSTRACT Objective: To explore the clinical efficacy and safety of denosumab combined with immune checkpoint inhibitor in the treatment of solid tumor with bone metastases. Methods: 60 patients with solid tumor bone metastases, admitted to Nantong Cancer Hospital from July 2020 to November 2022, were selected for the study and divided into two groups: observation group, n=18, and control group, n=42. The control group was treated with irbandronate plus tireilizumab, and the observation group was treated with tirelizumab plus dixulumab. Control group to carry out the Ibandronic acid + for Tislelizumab resistance to treatment, observation group to carry out for Tislelizumab + denosumab of resisting treatment. Comparison of treatment effect, the level of bone mineral density, bone related events, related indicators and safety. Results: The treatment control rate of the observation group was 82.86 %, which was higher than 54.76 % of the control group (P<0.05). Before treatment, there was no difference between the observation group and the control group in the change of right foot SOS (P>0.05). After treatment, compared with before treatment, both the observation group and the control group were increased, and the observation group was higher(P<0.05). The incidence of bone-related events was 22.22 % in the observation group and 50.00 % in the control group, with a lower incidence in the observation group(P<0.05). Before treatment, Pittsburgh Sleep Quality Index (PSQI), self-assessment of Anxiety and Depression (SAS), (SDS), and Assessment of Ability of Daily Living (ADL) scores were compared between the observation group and the control group (P>0.05). After treatment, compared with before treatment, the levels of all indexes in the observation group and the control group were decreased, and the observation group was lower (P<0.05). The incidence of adverse reactions was 44.44 % in the observation group and 52.38% in the control group(P>0.05). Conclusion: Denosumab combined with immune checkpoint inhibitors can effectively improve the treatment effect of solid tumor bone metastases, improve bone mineral density, reduce the risk of bone adverse events, improve the psychological and physiological indicators of patients, and promote the effective improvement of daily living ability, with high safety.