【摘要】 目的 探讨信迪利单抗联合安罗替尼治疗驱动基因阴性晚期肺腺癌的疗效及安全性。方法 选取2019年8月至2022年4月于福州肺科医院诊治的60例晚期肺腺癌患者。按不同治疗方法分为两组，每组30例，观察组给予信迪利单抗联合安罗替尼，对照组给予信迪利单抗联合培美曲塞和卡铂，比较两组的无进展生存期、近期临床疗效、不良反应发生情况和肿瘤标志物水平[癌胚抗原（CEA）和细胞角蛋白19片段抗原（CYFRA21-1）]。结果 观察组的客观缓解率（ORR）为43.3%，对照组为46.7%，观察组的疾病控制率（DCR）为93.3%，对照组为90.0%，但差异均无统计学意义（P> 0.05）。观察组中位无进展生存期为12个月（95%CI8.42～15.56），对照组中位无进展生存期为12个月（95%CI 5.42～18.58）(P> 0.05)。治疗前，两组CYFRA21-1及CEA比较无差异（P> 0.05）；治疗后，观察组CYFRA21-1高于对照组，CEA低于对照组，但差异无统计学意义（P> 0.05）。对照组并发症总发生率为36.67%，高于观察组的33.33%，但差异无统计学意义（P> 0.05）。结论 信迪利单抗联合安罗替尼治疗晚期肺腺癌不劣效于信迪利单抗联合培美曲塞和卡铂，不良反应可耐受，可作为不适宜化疗的晚期肺腺癌的一种治疗选择。更多还原

【Abstract】 Objective To investigate the therapeutic effects and safety profile of combining sintilimab with anlotinib for treating advanced lung adenocarcinoma in patients lacking driver genes. Methods A total of 60 patients were selected who with advanced lung adenocarcinoma treated at Fuzhou Pulmonary Hospital from August 2019 to April 2022. According to different treatment methods, they were divided into two groups, each consisting of 30 cases. The observation group was given sintilimab combined with anlotinib, and the control group was given sintilimab combined with pemetrexed and carboplatin. The progression-free survival, recent clinical efficacy,tumor marker levels [cytokeratin fragment antigen 21-1(CYFRA21-1) and carcinoembryonic antigen(CEA)] and adverse reaction occurrence of the two groups were compared. Results The objective response rate(ORR) of the observation group was 43.3%, and that of the control group was 46.7%. The disease control rate(DCR) of the observation group was 93.3%, and that of the control group was 90.0%, with no statistically significant difference(P>0.05). The median progression-free survival of the observation group was 12 months(95%CI 8.42-15.56), and that of the control group was 12 months(95%CI 5.42-18.58)(P>0.05). Before treatment, there was no difference in CYFRA21-1 and CEA between the two groups(P>0.05). After treatment, the CEA in the observation group was lower than that in the control group, and CYFRA21-1 was higher than that in the control group, with no statistically significant difference(P>0.05). The total incidence of complications in the observation group was 33.33%, lower than the 36.67% in the control group, with no statistically significant difference(P>0.05). Conclusions The combination of sintilimab and anlotinib is not inferior to the combination of sintilimab, pemetrexed,and carboplatin in the treatment of advanced lung adenocarcinoma. The adverse reactions are tolerable and can be considered as a treatment option for advanced lung adenocarcinoma patients who are not suitable for chemotherapy.更多还原