Objective To investigate the short-term effect of preoperative neoadjuvant chemoradiotherapy combined with programmed cell death 1 （PD-1） inhibitors on the treatment of ulcerative colitis related colorectal cancer （UCRCC）. Methods Clinical data of UCRCC patients who received PD-1 inhibitors combined with neoadjuvant therapy and surgically operated in the Second Hospital of Nanjing from March 2021 to December 2023 were retrospectively collected. Patients were divided into the control group （n=46） and combination group （n=34） based on preoperative treatment regimens. Patients in the control group received two cycles of capecitabine + oxaliplatin chemotherapy preoperatively, followed by two cycles of radiotherapy after a 2-week rest. Those in the combination group received PD-1 inhibitors every 3 weeks for two cycles, plus clinical management as the same as in the control group. All patients underwent surgery （total colorectal resection with ileostomy or radical intestinal tumor resection） 4-6 weeks after neoadjuvant chemoradiotherapy. The effect of neoadjuvant therapy, tumor markers, drug toxicity, side effects, perioperative indicators and postoperative pathology were compared between the two groups. Results Disease control rate in the combination group was significantly higher than that of the control group （P<0.05）. The levels of carbohydrate antigen 242, carbohydrate antigen 72-4, carcinoembryonic antigen and carbohydrate antigen 199 in the combination group were significantly lower than those of the control group （P<0.05）, and the percentage of tumor regression grades 0 and 1 was significantly higher compared to the control group. There were no significant differences in the incidence of toxic and side effects and perioperative indexes between the two groups （P>0.05）. Conclusion Preoperative neoadjuvant chemoradiotherapy combined with PD-1 inhibitors demonstrates favorable efficacy in controlling UCRCC, reducing tumor marker levels, improving postoperative pathological outcomes, and exhibiting an acceptable safety profile.
Key words
Neoadjuvant chemoradiotherapy /
PD-1 inhibitor /
Ulcerative colitis related colorectal cancer /
Surgical treatment
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References
[1] 滕熠,张晓丹,夏昌发,等.中国与全球癌症发病、死亡和患病对比及其预测分析:GLOBOCAN 2022数据解读[J].中华肿瘤防治杂志,2024,31(23):1413-1420.DOI:10.16073/j.cnki.cjcpt.2024.23.01.
[2] 中华医学会外科学分会结直肠外科学组.结直肠癌多学科综合治疗协作组诊疗模式中国专家共识(2023版)[J].中国实用外科杂志,2024,44(1):1-16.DOI:10.19538/j.cjps.issn1005-2208.2024.01.01.
[3] 马盛哲. 微卫星稳定型直肠癌新辅助放化疗联合免疫治疗的研究进展[J].肿瘤,2023,43(5):411-420.DOI:10.3781/j.issn.1000-7431.2023.2306-0317.
[4] 袁之俊,来茂德.结直肠癌分子分型与免疫治疗和靶向治疗[J].临床与实验病理学杂志,2024,40(6):561-566.DOI:10.13315/j.cnki.cjcep.2024.06.001.
[5] Sui QQ,Zhang X,Chen C,et al.Inflammation promotes resistance to immune checkpoint inhibitors in high microsatellite instability colorectal cancer[J].Nat Commun,2022,13(1):7316.DOI:10.1038/s41467-022-35096-6.
[6] 汪泓,罗文广,张红雁,等.直肠癌新辅助放化疗后病理完全缓解的临床预测因素分析[J].安徽医学,2024,45(9):1100-1105.DOI:10.3969/j.issn.1000-0399.2024.09.005.
[7] 朱智云,王德平,张兴飞.我院新型抗肿瘤药物医嘱点评及用药分析[J].肿瘤药学,2024,14(3):368-372.DOI:10.3969/j.issn.2095-1264.2024.03.15.
[8] 李杉,柳艳飞,刘倩,等.呋喹替尼联合信迪利单抗治疗晚期微卫星稳定型结直肠癌疗效观察[J].肿瘤防治研究,2023,50(12):1227-1231.DOI:10.3971/j.issn.1000-8578.2023.23.0578.
[9] 朱麒,刘迁,肖敏,等.信迪利单抗联合呋喹替尼治疗微卫星稳定型晚期结肠癌患者的临床疗效及对患者免疫功能的影响[J].中国免疫学杂志,2023,39(9):1922-1927.DOI:10.3969/j.issn.1000-484X.2023.09.021.
[10] Dong P,Wei WS,Jiang LJ,et al.Anlotinib combined with sintilimab as first-line treatment in patients with advanced non-clear cell renal cell carcinoma (nccRR):Preliminary results from an exploratory prospective multicentre clinical study[J].J Clin Oncol,2024,42(16_suppl):4544.DOI:10.1200/jco.2024.42.16_suppl.4544.
[11] Xu Q,Wang JJ,Sun Y,et al.Efficacy and safety of sintilimab plus anlotinib for PD-L1-positive recurrent or metastatic cervical cancer:a multicenter,single-arm,prospective phase II trial[J].J Clin Oncol,2022,40(16):1795-1805.DOI:10.1200/JCO.21.02091.
[12] 徐锰超,谢玉玺,邵元伟.磁共振弥散加权成像ADC值联合血清肿瘤标志物对结直肠癌患者术后复发转移的预测价值[J].中国CT和MRI杂志,2024,22(1):137-140.
[13] 李春霞,游瑞敏,刘丽珠,等.CA242围手术期变化模式及纵向轨迹与结直肠癌预后的关联:一项回顾性纵向队列研究[J].科学通报(英文版),2023,68(17):1875-1879.
[14] 田洁,付文华,张媛,等.恩度联合信迪利单抗注射液治疗晚期结直肠癌的效果及其对血清CA199、CEA、CYFRA21-1水平的影响[J].分子诊断与治疗杂志,2023,15(5):897-900.DOI:10.19930/j.cnki.jmdt.2023.05.025.
[15] Vitale E,Rizzo A,Maistrello L,et al.Sex differences in adverse events among cancer patients receiving immune checkpoint inhibitors:the MOUSEION-07 systematic review and meta-analysis[J].Sci Rep,2024,14:28309.DOI:10.1038/s41598-024-71746-z.
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