Study On The Effect Of PD-1 Immune Checkpoint Inhibitor Combine With Chemotherapy Neoadjuvant Treatment Of Stage ⅢA/ⅢB Lung Squamous Cell Carcinoma

Objective: To study the clinical effect of programmed cell death protein-1(PD-1)immune checkpoint inhibitor combined with chemotherapy preoperative neoadjuvant therapy in patients with stage IIIA/IIIB lung squamous cell carcinoma.To provide theoretical basis for the selection,promotion and application of neoadjuvant immunochemotherapy in patients with stage IIIA/IIIB lung squamous cell carcinoma.Methods: The clinical data of stage IIIA/IIIB lung squamous cell carcinoma patients who received neoadjuvant therapy in the same treatment group in the Department of Thoracic Surgery of Qinghai university affiliated Hospital from March1,2020 to May 31,2021 were collected and screened,and divided into experimental group and control group according to different treatment plans.The experimental group received neoadjuvant treatment regimen of PD-1 immune checkpoint inhibitor sintilimab,albumin-bound paclitaxel and Lobaplatin,while the control group received albumin-bound paclitaxel and Lobaplatin.General clinical data,adverse events,imaging evaluation effect after 2 cycles of treatment,data related to surgery and rehabilitation,postoperative complications,and pathological remission of patients in the two groups were collected.Then statistical analysis,comparative study and discussion were conducted and conclusions were drawn.Results: There were no significant differences in age,gender composition,smoking history,eastern cooperative oncology group(ECOG)score and tumor stage between 2 groups(P > 0.05).There were no significant differences in pruritus or maculopapule,thyroid dysfunction,increased liver transaminase and total bilirubin,increased myocardial injury markers,increased creatinine,nausea or vomiting,diarrhea,anemia,decreased platelet count and decreased white blood cell count(P >0.05).There is a significant difference in the overall imaging efficacy(P < 0.05),There were no significant differences in disease control rate(DCR),complete response(CR)and progressive disease(PD)(P > 0.05),while there were significant differences in objective response rate(ORR),partial response(PR)and stable disease(SD)(P < 0.05).There were no significant differences in operation rate,operation method,operation time,intraoperative blood loss,chest drainage flow on the first day after surgery,chest tube placement time and postoperative hospital stay(P > 0.05).There were no significant differences in persistent lung leakage(> 5 days),lung infection,bronchopleural fistula,incision infection and the total number of postoperative complications(P > 0.05),while there were significant differences in postoperative arrhythmia(P < 0.05).There were significant differences in major pathologic response(MPR)and complete pathologic response(CPR)(P < 0.05).Conclusion: Pd-1 immune checkpoint inhibitor combined with chemotherapy for preoperative neoadjuvant treatment of stage IIIA/IIIB lung squamous cell carcinoma :(1)The PR rate and ORR of patients were significantly improved,and the preoperative tumor reduction and stage reduction effects were significant;(2)The incidence of postoperative arrhythmia increases,which requires vigilance;(3)It can significantly improve the MPR rate and CPR rate of patients,and has a good efficacy in killing tumor cells,and the recent clinical effect is significant;(4)This scheme is suitable for clinical promotion in the treatment of stage IIIA/IIIB lung squamous cell carcinoma.