| Objective:To investigate the short-term clinical effect of programmed death molecule-1(PD-1)immune checkpoint inhibitor Tirellizumab combined with neoadjuvant chemotherapy in patients with stage IIA/IIB lung squamous cell carcinoma.To provide A theoretical basis for the selection,promotion and application of neoadjuvant immunotherapy combined with chemotherapy in patients with stage III A/ III B lung squamous cell carcinoma.Method:This study intends to collect the data of patients with stage III A/III B lung squamous cell carcinoma who received neoadjuvant therapy from the Department of Thoracic Surgery of the Second Affiliated Hospital of Nanchang University during the period from September 1,2019 to June 31,2022,and divide them into two groups according to their treatment plan,namely,experimental group and control group.PD-1 immune checkpoint inhibitor Tirelizumab,albumin-bound paclitaxel plus carboplatin were used as neoadjuvant therapy in the experimental group,and albumin-bound paclitaxel plus carboplatin was used as neoadjuvant therapy in the control group.General clinical data,adverse reactions,radiological evaluation results after 2 cycles of treatment,data related to operation and rehabilitation,postoperative complications,and pathological remission were observed in the two groups.Results:There were no significant differences in age,gender composition,smoking history,Eastern Cooperative Oncology Group(ECOG)score and tumor stage between the two groups(P>0.05).In the comparison of adverse events,the comparison of thyroid dysfunction between the two groups was significantly higher in the experimental group than in the control group.The difference was statistically significant(P<0.05),but there was no statistically significant difference between the two groups in pruritis or maculopapular rash,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 were significant differences in the overall radiological effect(P<0.05),but no significant differences in disease control rate(DCR),complete response rate(CR)and disease progression(PD)(P>0.05).The experimental group was higher than the control group in objective response rate(ORR)and partial response rate(PR).There was a significant difference(P<0.05),and the comparison of disease stability(SD)in the control group was higher than that in the experimental group(P<0.05).There was no statistical significance in the indexes of operation rate,operation method,operation time,intraoperative blood loss,thoracic drainage volume on the first day after surgery,thoracic tube placement time,postoperative hospitalization days between the two groups(P>0.05).There was no statistical significance in the total number of postoperative pulmonary air leakage >5 days,pulmonary infection,chylous pleural effusion,incision infection,arrhythmia and postoperative complications in 2 groups(P>0.05).In the comparison of pathological response(MPR)and complete pathological response(CPR),the experimental group was higher than the control group,with significant difference(P<0.05).Conclusion:Preoperative combination of PD-1 immune checkpoint inhibitor and neoadjuvant chemotherapy in patients with stage ⅢA/ⅢB lung squamous cell carcinoma:(1)The incidence of thyroid dysfunction in patients is relatively high,which requires attention;(2)PR rate and ORR were significantly increased,and preoperative tumor shrinkage and staging were significantly improved;(3)It can significantly increase the MPR and CPR rates of patients,have a strong killing effect on cancer cells,and the short-term efficacy is good;(4)This method showed A good short-term clinical effect in the preoperative neoadjuvant patients with stage III A/III B lung squamous cell carcinoma. |
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