Efficacy And Safety Of PD-1 Inhibitor Combined With Concurrent Radiotherapy And Chemotherapy In The Treatment Of Advanced Cervical Cancer

Purpose:Discuss and observe the adverse reactions and safety of PD-1 immune checkpoint blocker combined with chemotherapy in the treatment of advanced cervical cancer patients.In order to explore whether the intervention of PD-1 inhibitors can accelerate the regression of tumor volume in cervical cancer patients during synchronous radiotherapy and chemotherapy,and provide theoretical reference for changing the timing of the second phase plan,improving patients’ precise treatment and prognosis.Methods:The clinical data of suffere with cervical cancer who were cured in the subsidiary hospital of Inner Mongolia Medical University from January 1,2019 to December 31,2020 were collected.According to the inclusion criteria,58 patients were enrolled.Among them,28 suffers in the inspection therapy group were treated with PD-1 inhibitor(cyparizumab or sindrizumab)combined with concurrent radiotherapy and chemotherapy.The other group of patients chose the same radiotherapy and chemotherapy treatment as the observation group.Based on the patient’s previous treatment methods and relevant data,the ORR(objective response rate),DCR(disease control rate),serum carbohydrate antigen 125(CA125),and squamous cell carcinoma antigen of the observation group and the other group are subtypes of tumor associated antigen TA-4,which is a glycoprotein squamous cell carcinoma antigen(SCC)and an acidic glycoprotein with human embryonic antigen characteristics,Carcinoembryonic antigen(CEA)and lymphocyte count present on the surface of cancer cells derived from the differentiation of endodermal cells.The incidence of adverse reactions was observed.The contour of the cervical tumor on the CT images of the two groups of patients located before radiotherapy and on the CT images of the two groups of patients located after adiotherapy for 3 weeks was drawn,and the volume of the cervical cancer was statisticed using the function of the planning channel,in order to discuss whether there was a significant difference in the tumor regression among the divide into groups.Apply statistical software SPSS 25.0 to analyze the data and test the level α= 0.05,P<0.05,the difference was statistically significant.Results:1.There are not statistical draw a line between between groups in the measurement of cancer bulk on the location CT image.The volume of cervical tumor on the location CT image after treatment was statistically significant at 3 weeks after radiotherapy.The addition of PD-1 inhibitor on the basis of concurrent radiotherapy and chemotherapy can accelerate the regression of tumor volume and provide more accurate treatment.2.SCC and CEA in serum were significantly different between the two groups after treatment(Z=-3.532,P<0.05)and(Z=-2.700,P<0.05);The P value of lymphocyte count after treatment was less than 0.05,with significant difference.3.The research results on the recent efficacy of patients in the observation group and the control group showed that the observation group had CR: 64.3%,PR: 32.1%,SD: 3.6%,PD:0%;Control group CR: 36.7%,PR: 43.3%,SD: 20.0%,PD: 0%;The short-term efficacy CR of the observation group and the control group were 64.3% and 36.7%,respectively,with a statistically significant difference(P<0.05).The ORR of the two groups of patients was 96.4%and 80.0%,respectively,with a statistically significant difference(P<0.05);The DCR of both groups was 100%,with no significant statistical difference(P>0.05).4.In the observation and analysis of the treatment safety of the two groups of patients,we found that the incidence of rash in the observation group was 3 cases(10.7%)of 28 cases,and 1 case(3.3%)of 30 cases in the control group,both of which were I-II,There was no statistically significant difference(P=0.106);There were no significant differences in the occurrence and incidence of bone marrow suppression or severe adverse reactions of grade 3or above among patients in different treatment groups who chose different treatment modes(P>0.05);At the level of adverse side effects and incidence of adverse reactions in both groups of patients two treatment regimens(P>0.05);There was no statistically significant difference in the incidence and occurrence of radiation-induced acute and chronic bladder mucositis between patients in the PD-1 immune target inhibition group and those in the basic treatment group without immune drugs(P>0.05);In a total of 58 patients from both groups,adverse reactions and related side effects of liver function index damage were distributed in grades I to II,and no patients had any adverse reactions or side effects in grades III to IV.There was no significant difference in the incidence and incidence of thyroid dysfunction,injury,and liver dysfunction between the two groups(p>0.05).Conclusion:1.PD-1 inhibitor combined with concurrent radiotherapy and chemotherapy can significantly improve the CR rate and ORR The incidence of disease among recipients of advanced cervical cancer did not increase the adverse reactions associated with increased immunity to cure the disease.PD-1 target blocker has good short-term efficacy and safety for advanced cervical cancer based on the treatment mode of concurrent radiotherapy plus chemotherapy.2.Compared with the volume of the cervical tumor on the CT image of the location before radiotherapy and the CT image of the secondary location after 3 weeks of radiotherapy,the volume of the tumor was significantly reduced after the combination of PD-1 inhibitor.It is suggested that the secondary location should be carried out in advance for the patients with advanced cervical cancer who use PD-1 inhibitor on the basis of synchronous radiotherapy and chemotherapy compared with the patients with conventional synchronous radiotherapy and chemotherapy to ensure the accurate implementation of radiotherapy.3.The addition of PD-1 inhibitor to the standard synchronous radiochemotherapy regimen for patients with advanced cervical cancer did not increase the side effects associated with treatment.The application of PD-1 inhibitor in patients with advanced cervical cancer did not increase the safety risk,and the adverse events could be managed.