背景:下咽和喉鳞状细胞癌(SCC)占头颈部SCC的25-30%。全喉切除术,虽然有效,损害生活质量。免疫检查点抑制剂如Camrelizumab在喉部保存方面具有潜力。该研究调查了卡姆瑞珠单抗联合TP方案作为晚期下咽和喉SCC喉部保留的新辅助疗法。
方法:对2019年10月1日至2022年10月25日在中山大学肿瘤防治中心确诊的下咽喉部局部晚期SCC患者进行回顾性研究。使用RECIST1.1标准评估了联合卡姆瑞珠单抗(200mg)和TP方案(260mg/m2的白蛋白结合紫杉醇和60mg/m2的顺铂)的一线治疗的疗效。结果包括总生存期(OS),无进展生存期(PFS),无喉切除术生存率(LFS),和响应率。
结果:在纳入的71名患者中,中位年龄为60.7岁.一线治疗后,90.1%表现出总体反应。一年和两年OS率分别为91.5%和84.3%,分别。一年和两年的PFS率分别为92.9%和83.9%,分别,LFS分别为85.6%和73.2%。初始T4阶段与简化的OS和LFS显著相关。皮肤反应是主要的不良事件。
结论:Camrelizumab-TP方案对晚期下咽/喉部SCC患者显示了有希望的结果,表现出高反应率,操作系统,LFS,将其定位为喉部保存的潜在主要选择。进一步全面,随机对照研究是必要的,以验证这些初步观察和阐明方案的全部临床疗效,以优化喉结局。
BACKGROUND: Hypopharyngeal and laryngeal squamous cell carcinoma (SCC) account for 25-30% of head and neck SCC. Total laryngectomy, while effective, compromises the quality of life. Immune checkpoint inhibitors such as Camrelizumab offer potential in laryngeal preservation. The study investigated Camrelizumab combined with TP regimen as a neoadjuvant therapy for laryngeal preservation in advanced hypopharyngeal and laryngeal SCC.
METHODS: A retrospective study was conducted at Sun Yat-sen University Cancer Center on patients diagnosed with locally advanced SCC of the hypopharynx and
larynx from October 1, 2019, to October 25, 2022. The efficacy of a first-line treatment combining Camrelizumab (200 mg) and TP regimen (Albumin-bound paclitaxel at 260 mg/m2 and Cisplatin at 60 mg/m2) was evaluated using RECIST 1.1 criteria. Outcomes included overall survival (OS), progression-free survival (PFS), laryngectomy-free survival (LFS), and response rates.
RESULTS: Of the 71 included patients, the median age was 60.7 years. Post the first-line treatment, 90.1% demonstrated an overall response. The one-year and two-year OS rates were 91.5% and 84.3%, respectively. One-year and two-year PFS rates were 92.9% and 83.9%, respectively, with LFS at 85.6% and 73.2%. The initial T4 stage as significantly associated with reduced OS and LFS. Skin reaction was the predominant adverse event.
CONCLUSIONS: The Camrelizumab-TP regimen demonstrated promising results for advanced hypopharyngeal/laryngeal SCC patients, exhibiting high response rates, OS, and LFS, positioning it as a potential primary option for laryngeal preservation. Further comprehensive, randomized controlled studies are imperative to validate these initial observations and elucidate the regimen\'s full clinical efficacy in optimizing laryngeal outcomes.