Login Register Cart 0
Generic placeholder image

当代肿瘤药物靶点

Editor-in-Chief

ISSN (Print): 1568-0096
ISSN (Online): 1873-5576

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe Translate in English
Research Article

新辅助免疫治疗联合化疗对食管癌肺功能及术后肺部并发症影响的回顾性研究

卷 24, 期 10, 2024

发表于: 17 January, 2024

页: [1061 - 1070] 页: 10

弟呕挨: 10.2174/0115680096280761231229055929

价格: $65

conference banner
摘要

背景：针对PD-1或PD-L1的新辅助免疫治疗联合化疗(NICT)可以提高局部晚期EC的根治性切除和生存率。然而，它可能损害肺功能，NICT对EC患者肺功能和术后肺并发症的影响尚不清楚。本研究旨在探讨NICT是否会影响EC患者的肺功能和术后肺并发症。 方法：本研究回顾性招募了2021年1月至2022年6月在天津医科大学肿瘤研究所医院食管癌科接受NICT治疗的220例EC患者。比较NICT前后肺功能的变化。采用Logistic回归分析分别分析肺功能和临床特征与术后肺部并发症的相关性。 结果：NICT后FEV1% pred、FVC、FVC% pred和FEV1/FVC%显著升高，p值分别为0.018、0.005、0.001和0.036。相比之下，NICT前DLCO显著下降(8.92 μ} 2.34 L vs. NICT后7.79 μ} 2.30 L);P < 0.05)， DLCO% pred (NICT前为102.97 μ} 26.22%， NICT后为90.18 μ} 25.04%;P < 0.05)。高DLCO和基线水平的DLCO%是NICT后EC患者DLCO降低的危险因素。高龄、吸烟史、NICT术后FEV1%、基线及治疗后FVC%是术后肺部并发症的危险因素，p值分别为0.043、0.038、0.048、0.034、0.004。NICT后DLCO水平虽有所下降，但未增加术后肺部并发症的发生率。 结论：NICT可改善肺通气功能，但也可降低EC患者DLCO和DLCO%。然而，NICT后DLCO的降低并未增加术后肺部并发症的风险。

关键词: 食管癌、NICT、外科、肺功能、肺并发症、急性肺损伤。

« Previous Next »
图形摘要

[1]
He, F.; Wang, J.; Liu, L.; Qin, X.; Wan, Z.; Li, W.; Ping, Z. Esophageal cancer: Trends in incidence and mortality in China from 2005 to 2015. Cancer Med., 2021, 10(5), 1839-1847.
[http://dx.doi.org/10.1002/cam4.3647] [PMID: 33594825]
[2]
van Hagen, P.; Hulshof, M.C.C.M.; van Lanschot, J.J.B.; Steyerberg, E.W.; Henegouwen, M.I.B.; Wijnhoven, B.P.L.; Richel, D.J.; Nieuwenhuijzen, G.A.P.; Hospers, G.A.P.; Bonenkamp, J.J.; Cuesta, M.A.; Blaisse, R.J.B.; Busch, O.R.C.; ten Kate, F.J.W.; Creemers, G.J.; Punt, C.J.A.; Plukker, J.T.M.; Verheul, H.M.W.; Bilgen, E.J.S.; van Dekken, H.; van der Sangen, M.J.C.; Rozema, T.; Biermann, K.; Beukema, J.C.; Piet, A.H.M.; van Rij, C.M.; Reinders, J.G.; Tilanus, H.W.; van der Gaast, A. Preoperative chemoradiotherapy for esophageal or junctional cancer. N. Engl. J. Med., 2012, 366(22), 2074-2084.
[http://dx.doi.org/10.1056/NEJMoa1112088] [PMID: 22646630]
[3]
Chan, K.K.W.; Saluja, R.; Delos Santos, K.; Lien, K.; Shah, K.; Cramarossa, G.; Zhu, X.; Wong, R.K.S. Neoadjuvant treatments for locally advanced, resectable esophageal cancer: A network meta-analysis. Int. J. Cancer, 2018, 143(2), 430-437.
[http://dx.doi.org/10.1002/ijc.31312] [PMID: 29441562]
[4]
Rittmeyer, A.; Barlesi, F.; Waterkamp, D.; Park, K.; Ciardiello, F.; von Pawel, J.; Gadgeel, S.M.; Hida, T.; Kowalski, D.M.; Dols, M.C.; Cortinovis, D.L.; Leach, J.; Polikoff, J.; Barrios, C.; Kabbinavar, F.; Frontera, O.A.; De Marinis, F.; Turna, H.; Lee, J.S.; Ballinger, M.; Kowanetz, M.; He, P.; Chen, D.S.; Sandler, A.; Gandara, D.R. Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): A phase 3, open-label, multicentre randomised controlled trial. Lancet, 2017, 389(10066), 255-265.
[http://dx.doi.org/10.1016/S0140-6736(16)32517-X] [PMID: 27979383]
[5]
Smyth, E.C.; Gambardella, V.; Cervantes, A.; Fleitas, T. Checkpoint inhibitors for gastroesophageal cancers: Dissecting heterogeneity to better understand their role in first-line and adjuvant therapy. Ann. Oncol., 2021, 32(5), 590-599.
[http://dx.doi.org/10.1016/j.annonc.2021.02.004] [PMID: 33609722]
[6]
Janjigian, Y.Y.; Shitara, K.; Moehler, M.; Garrido, M.; Salman, P.; Shen, L.; Wyrwicz, L.; Yamaguchi, K.; Skoczylas, T.; Campos Bragagnoli, A.; Liu, T.; Schenker, M.; Yanez, P.; Tehfe, M.; Kowalyszyn, R.; Karamouzis, M.V.; Bruges, R.; Zander, T.; Pazo-Cid, R.; Hitre, E.; Feeney, K.; Cleary, J.M.; Poulart, V.; Cullen, D.; Lei, M.; Xiao, H.; Kondo, K.; Li, M.; Ajani, J.A. First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): A randomised, open-label, phase 3 trial. Lancet, 2021, 398(10294), 27-40.
[http://dx.doi.org/10.1016/S0140-6736(21)00797-2] [PMID: 34102137]
[7]
Postow, M.A.; Sidlow, R.; Hellmann, M.D. Immune-related adverse events associated with immune checkpoint blockade. N. Engl. J. Med., 2018, 378(2), 158-168.
[http://dx.doi.org/10.1056/NEJMra1703481] [PMID: 29320654]
[8]
Hong, Z.N.; Zhang, Z.; Chen, Z.; Weng, K.; Peng, K.; Lin, J.; Kang, M. Safety and feasibility of esophagectomy following combined neoadjuvant immunotherapy and chemotherapy for locally advanced esophageal cancer: A propensity score matching. Esophagus, 2022, 19(2), 224-232.
[http://dx.doi.org/10.1007/s10388-021-00899-x] [PMID: 34988773]
[9]
Abou-Jawde, R.M.; Mekhail, T.; Adelstein, D.J.; Rybicki, L.A.; Mazzone, P.J.; Caroll, M.A.; Rice, T.W. Impact of induction concurrent chemoradiotherapy on pulmonary function and postoperative acute respiratory complications in esophageal cancer. Chest, 2005, 128(1), 250-255.
[http://dx.doi.org/10.1378/chest.128.1.250] [PMID: 16002943]
[10]
Gao, W.; Wang, M.; Su, P.; Zhang, F.; Huang, C.; Tian, Z. Risk factors of cervical anastomotic leakage after mckeown minimally invasive esophagectomy: Focus on preoperative and intraoperative lung function. Ann. Thorac. Cardiovasc. Surg., 2021, 27(2), 75-83.
[http://dx.doi.org/10.5761/atcs.oa.20-00139] [PMID: 33087661]
[11]
Torre-Bouscoulet, L.; Muñoz-Montaño, W.R.; Martínez-Briseño, D.; Lozano-Ruiz, F.J.; Fernández-Plata, R.; Beck-Magaña, J.A.; García-Sancho, C.; Guzmán-Barragán, A.; Vergara, E.; Blake-Cerda, M.; Gochicoa-Rangel, L.; Maldonado, F.; Arroyo-Hernández, M.; Arrieta, O. Abnormal pulmonary function tests predict the development of radiation-induced pneumonitis in advanced non-small cell lung Cancer. Respir. Res., 2018, 19(1), 72.
[http://dx.doi.org/10.1186/s12931-018-0775-2] [PMID: 29690880]
[12]
Suzuki, Y.; Inui, N.; Karayama, M.; Imokawa, S.; Yamada, T.; Yokomura, K.; Asada, K.; Kusagaya, H.; Kaida, Y.; Matsuda, H.; Koshimizu, N.; Toyoshima, M.; Masuda, M.; Hayakawa, H.; Hozumi, H.; Furuhashi, K.; Enomoto, N.; Fujisawa, T.; Nakamura, Y.; Suda, T. Effect of PD-1 inhibitor on exhaled nitric oxide and pulmonary function in non-small cell lung cancer patients with and without COPD. Int. J. Chron. Obstruct. Pulmon. Dis., 2019, 14(14), 1867-1877.
[http://dx.doi.org/10.2147/COPD.S214610] [PMID: 31686799]
[13]
Franzen, D.; Schad, K.; Kowalski, B.; Clarenbach, C.F.; Stupp, R.; Dummer, R.; Kohler, M. Ipilimumab and early signs of pulmonary toxicity in patients with metastastic melanoma: A prospective observational study. Cancer Immunol. Immunother., 2018, 67(1), 127-134.
[http://dx.doi.org/10.1007/s00262-017-2071-2] [PMID: 28983773]
[14]
Miller, M.R.; Hankinson, J.; Brusasco, V.; Burgos, F.; Casaburi, R.; Coates, A.; Crapo, R.; Enright, P.; van der Grinten, C.P.; Gustafsson, P.; Jensen, R.; Johnson, D.C.; MacIntyre, N.; McKay, R.; Navajas, D.; Pedersen, O.F.; Pellegrino, R.; Viegi, G.; Wanger, J. Standardisation of spirometry. Eur. Respir. J., 2005, 26(2), 319-338.
[http://dx.doi.org/10.1183/09031936.05.00034805] [PMID: 16055882]
[15]
Crapo, R.O.; Morris, A.H.; Gardner, R.M. Reference spirometric values using techniques and equipment that meet ATS recommendations. Am. Rev. Respir. Dis., 1981, 123(6), 659-664.
[http://dx.doi.org/10.1164/arrd.1981.123.6.659] [PMID: 7271065]
[16]
Schwartz, L.H.; Litière, S.; de Vries, E.; Ford, R.; Gwyther, S.; Mandrekar, S.; Shankar, L.; Bogaerts, J.; Chen, A.; Dancey, J.; Hayes, W.; Hodi, F.S.; Hoekstra, O.S.; Huang, E.P.; Lin, N.; Liu, Y.; Therasse, P.; Wolchok, J.D.; Seymour, L. RECIST 1.10-Update and clarification: From the RECIST committee. Eur. J. Cancer, 2016, 62, 132-137.
[http://dx.doi.org/10.1016/j.ejca.2016.03.081] [PMID: 27189322]
[17]
Avendano, C.E.; Flume, P.A.; Silvestri, G.A.; King, L.B.; Reed, C.E. Pulmonary complications after esophagectomy. Ann. Thorac. Surg., 2002, 73(3), 922-926.
[http://dx.doi.org/10.1016/S0003-4975(01)03584-6] [PMID: 11899202]
[18]
Dimopoulou, I.; Galani, H.; Dafni, U.; Samakovli, A.; Roussos, C.; Dimopoulos, M.A. A prospective study of pulmonary function in patients treated with paclitaxel and carboplatin. Cancer, 2002, 94(2), 452-458.
[http://dx.doi.org/10.1002/cncr.10182] [PMID: 11900231]
[19]
Chen, X.; Du, M.; Tang, H.; Wang, H.; Fang, Y.; Lin, M.; Yin, J.; Tan, L.; Shen, Y. Comparison of pulmonary function changes between patients receiving neoadjuvant chemotherapy and chemoradiotherapy prior to minimally invasive esophagectomy: A randomized and controlled trial. Langenbecks Arch. Surg., 2022, 407(7), 2673-2680.
[http://dx.doi.org/10.1007/s00423-022-02646-x] [PMID: 36006505]
[20]
Zhu, Y.; Li, J.Q.; Chang, Q.; Qiang, H.P.; Lu, J.H.; Feng, H.; Shen, Y.C.; Qian, J.L.; Chu, T.Q. [Impact of neoadjuvant immunotherapy on pulmonary function and perioperative outcomes in patients with resectable non-small cell lung cancer]. Zhonghua Yi Xue Za Zhi, 2022, 102(6), 393-398.
[http://dx.doi.org/10.3760/cma.j.cn112137-20211009-02226] [PMID: 35144337]
[21]
Cerfolio, R.J.; Bryant, A.S. Different diffusing capacity of the lung for carbon monoxide as predictors of respiratory morbidity. Ann. Thorac. Surg., 2009, 88(2), 405-411.
[http://dx.doi.org/10.1016/j.athoracsur.2009.04.015] [PMID: 19632384]
[22]
Pellegrino, R.; Viegi, G.; Brusasco, V.; Crapo, R.O.; Burgos, F.; Casaburi, R.; Coates, A.; van der Grinten, C.P.; Gustafsson, P.; Hankinson, J.; Jensen, R.; Johnson, D.C.; MacIntyre, N.; McKay, R.; Miller, M.R.; Navajas, D.; Pedersen, O.F.; Wanger, J. Interpretative strategies for lung function tests. Eur. Respir. J., 2005, 26(5), 948-968.
[http://dx.doi.org/10.1183/09031936.05.00035205] [PMID: 16264058]
[23]
Goense, L.; Meziani, J.; Bülbül, M.; Braithwaite, S.A.; van Hillegersberg, R.; Ruurda, J.P. Pulmonary diffusion capacity predicts major complications after esophagectomy for patients with esophageal cancer. Dis. Esophagus, 2019, 32(3), doy082.
[http://dx.doi.org/10.1093/dote/doy082] [PMID: 30239639]
[24]
Ferguson, M. K.; Lehman, A. G.; Bolliger, C. T.; Brunelli, A. The role of diffusing capacity and exercise tests. Thorac Surg Clin., 2008, 18(1), 9-17.
[http://dx.doi.org/10.1016/j.thorsurg.2007.11.001]
[25]
Burton, C.; Kaczmarski, R.; Jan-Mohamed, R. Interstitial pneumonitis related to rituximab therapy. N. Engl. J. Med., 2003, 348(26), 2690-2691.
[http://dx.doi.org/10.1056/NEJM200306263482619] [PMID: 12826649]
[26]
Rivera, M.P.; Detterbeck, F.C.; Socinski, M.A.; Moore, D.T.; Edelman, M.J.; Jahan, T.M.; Ansari, R.H.; Luketich, J.D.; Peng, G.; Monberg, M.; Obasaju, C.K.; Gralla, R.J. Impact of preoperative chemotherapy on pulmonary function tests in resectable early-stage non-small cell lung cancer. Chest, 2009, 135(6), 1588-1595.
[http://dx.doi.org/10.1378/chest.08-1430] [PMID: 19188545]
[27]
Fujimori, K.; Yokoyama, A.; Kurita, Y.; Uno, K.; Saijo, N. Paclitaxel-induced cell-mediated hypersensitivity pneumonitis. Diagnosis using leukocyte migration test, bronchoalveolar lavage and transbronchial lung biopsy. Oncology, 1998, 55(4), 340-344.
[http://dx.doi.org/10.1159/000011873] [PMID: 9663424]
[28]
Horning, S.J.; Adhikari, A.; Rizk, N.; Hoppe, R.T.; Olshen, R.A. Effect of treatment for Hodgkin’s disease on pulmonary function: Results of a prospective study. J. Clin. Oncol., 1994, 12(2), 297-305.
[http://dx.doi.org/10.1200/JCO.1994.12.2.297] [PMID: 7509383]
[29]
Goense, L.; van Rossum, P.S.N.; Tromp, M.; Joore, H.C.; van Dijk, D.; Kroese, A.C.; Ruurda, J.P.; van Hillegersberg, R. Intraoperative and postoperative risk factors for anastomotic leakage and pneumonia after esophagectomy for cancer. Dis. Esophagus, 2016, 30(1), 1-10.
[http://dx.doi.org/10.1111/dote.12517] [PMID: 27353216]
[30]
Ferguson, M.K.; Celauro, A.D.; Prachand, V. Assessment of a scoring system for predicting complications after esophagectomy. Dis. Esophagus, 2011, 24(7), 510-515.
[http://dx.doi.org/10.1111/j.1442-2050.2011.01185.x] [PMID: 21418123]
[31]
Law, S.; Wong, K.H.; Kwok, K.F.; Chu, K.M.; Wong, J. Predictive factors for postoperative pulmonary complications and mortality after esophagectomy for cancer. Ann. Surg., 2004, 240(5), 791-800.
[http://dx.doi.org/10.1097/01.sla.0000143123.24556.1c] [PMID: 15492560]
[32]
Ferguson, M.K.; Celauro, A.D.; Prachand, V. Prediction of major pulmonary complications after esophagectomy. Ann. Thorac. Surg., 2011, 91(5), 1494-1501.
[http://dx.doi.org/10.1016/j.athoracsur.2010.12.036] [PMID: 21524462]
[33]
Sunpaweravong, S.; Ruangsin, S.; Laohawiriyakamol, S.; Mahattanobon, S.; Geater, A. Prediction of major postoperative complications and survival for locally advanced esophageal carcinoma patients. Asian J. Surg., 2012, 35(3), 104-109.
[http://dx.doi.org/10.1016/j.asjsur.2012.04.029] [PMID: 22884266]
[34]
Klevebro, F.; Elliott, J.A.; Slaman, A.; Vermeulen, B.D.; Kamiya, S.; Rosman, C.; Gisbertz, S.S.; Boshier, P.R.; Reynolds, J.V.; Rouvelas, I.; Hanna, G.B.; van Berge Henegouwen, M.I.; Markar, S.R. Cardiorespiratory comorbidity and postoperative complications following esophagectomy: A european multicenter cohort study. Ann. Surg. Oncol., 2019, 26(9), 2864-2873.
[http://dx.doi.org/10.1245/s10434-019-07478-6] [PMID: 31183640]
[35]
Brahmer, J.R.; Lacchetti, C.; Schneider, B.J.; Atkins, M.B.; Brassil, K.J.; Caterino, J.M.; Chau, I.; Ernstoff, M.S.; Gardner, J.M.; Ginex, P.; Hallmeyer, S.; Holter Chakrabarty, J.; Leighl, N.B.; Mammen, J.S.; McDermott, D.F.; Naing, A.; Nastoupil, L.J.; Phillips, T.; Porter, L.D.; Puzanov, I.; Reichner, C.A.; Santomasso, B.D.; Seigel, C.; Spira, A.; Suarez-Almazor, M.E.; Wang, Y.; Weber, J.S.; Wolchok, J.D.; Thompson, J.A. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American society of clinical oncology clinical practice guideline. J. Clin. Oncol., 2018, 36(17), 1714-1768.
[http://dx.doi.org/10.1200/JCO.2017.77.6385] [PMID: 29442540]
[36]
Epler, G.R.; McLoud, T.C.; Gaensler, E.A.; Mikus, J.P.; Carrington, C.B. Normal chest roentgenograms in chronic diffuse infiltrative lung disease. N. Engl. J. Med., 1978, 298(17), 934-939.
[http://dx.doi.org/10.1056/NEJM197804272981703] [PMID: 642974]

Rights & Permissions Print Cite
Article Metrics
24
1
Wayfinder Image
© 2024 Bentham Science Publishers | Privacy Policy