【摘要】 目的 在驱动基因阴性老年晚期非小细胞肺癌（NSCLC）患者中使用安罗替尼联合免疫检查点抑制剂一线治疗，观察其对患者的近期疗效、生活质量影响及不良反应。方法 选取2020年7月至2023年6月江阴市人民医院肿瘤中心及呼吸科收治的37例驱动基因阴性的老年晚期NSCLC患者资料进行回顾性分析。所有患者均采用安罗替尼联合免疫检查点抑制剂（替雷利珠单抗）方案，治疗4个周期评价疗效及生活质量变化，治疗期间观察不良反应，对患者持续随访至2024年11月30日统计生存状态。结果 治疗4个周期后，37例患者客观缓解率为43.24%(16/37)，疾病控制率为67.57%(25/37)，中位肿瘤无进展生存时间为8.7个月。相较于治疗前，治疗4个周期后，患者生活改善率为56.76%(21/37)。治疗期间，最常见的Ⅰ～Ⅱ级不良反应主要包括高血压（17/37,45.95%）、乏力（14/37,37.84%）和手足综合征（12/37,32.43%），Ⅲ～Ⅳ级不良反应包括皮疹（5/37,13.51%）、口腔溃疡（3/37,8.11%）、高血压（2/37,5.41%）和手足综合征（2/37,5.41%）。结论 在驱动基因阴性老年晚期NSCLC患者中使用安罗替尼联合PD-1抑制剂一线治疗疗效良好，整体安全性良好，有效改善患者生活质量。更多还原

【Abstract】 Objective To perform first-line therapy with anlotinib combined with immune checkpoint inhibitor for elderly patients with driver gene-negative advanced non-small cell lung cancer(NSCLC), and observe the influence on efficacy, quality of life and adverse reactions. Methods A retrospective analysis was performed on the data of 37 elderly patients with driver gene-negative advanced NSCLC in tumor center and respiratory department of Jiangyin People’s Hospital from July 2020 to June 2023. All patients were treated with anlotinib combined with immune checkpoint inhibitor(tislelizumab) for 4 cycles. The efficacy after treatment, adverse reactions during treatment and quality of life were observed. The patients were continuously followed up until November 30, 2024, and the survival status was counted. Results After 4 cycles of treatment, the objective remission rate, disease control rate and median progression-free survival time of 37 patients were 43.24%(16/37), 67.57%(25/37) and 8.7 months. Compared with before treatment, the improvement rate of quality of life was 56.76%(21/37) after 4 cycles of treatment. During treatment, grade Ⅰ-Ⅱ adverse reactions mainly included hypertension(17/37,45.95%), fatigue(14/37, 37.84%) and hand-foot syndrome(12/37, 32.43%). Grade Ⅲ-Ⅳ adverse reactions included skin rash(5/37,13.51%), oral ulcer(3/37, 8.11%), hypertension(2/37, 5.41%) and hand-foot syndrome(2/37, 5.41%). Conclusions The first-line treatment regimen with anlotinib and PD-1 inhibitor has good efficacy on elderly patients with driver gene-negative advanced NSCLC, and it has good overall safety and can effectively improve the quality of life.更多还原