Clinical Exploration Of Platinum Combined With Paclitaxel In The First-line Treatment Of Advanced Thymic Squamous Cell Carcinoma

Objective:To analyze the efficacy and safety of first-line chemotherapy combined with paclitaxel in patients,and to explore the factors affecting the prognosis.Methods:From July 1,2012 to June 30,2022,patients with histologically confirmed advanced thymic squamous cell carcinoma who received platinum combined with paclitaxel as the first-line treatment in our hospital were enrolled in this study.The clinical data and basic characteristics of these patients were collected and followed up.The clinical characteristics of these patients were analyzed,the Kaplan-Meier method was used to draw the survival curve,and the Log-rank test was used for univariate analysis.P<0.05 indicated that the difference was statistically significant.Results:A total of 51 patients with thymic squamous cell carcinoma were enrolled in this study.The median follow-up time was 53.4 months.The disease control rate(DCR)was 74.5%,and the objective response rate(ORR)was 35.3%.There was no complete remission(CR)case.There were 18 patients(35.3%)with partial remission(PR),20 patients(39.2%)with stable disease(SD),13 patients(25.5%)with progressive disease(PD).Median overall survival(OS)was 43.2 months(95%CI:30.62-55.78),and median progression-free survival(PFS)was 7.6 months(95%CI:6.36-8.90),and cisplatin-based chemotherapy was superior to carboplatin-based chemotherapy in terms of ORR,median PFS,and median OS.Hematological toxicity was the most common adverse reaction,and 22 patients(43.1%)had grade 3-4 hematological toxicity,including 13 patients(25.5%)with leukopenia,8 patients(15.7%)with neutropenia,and 1 patient(2.0%)with thrombocytopenia.All the above adverse reactions returned to normal after symptomatic treatment,and no treatment-related death occurred.The median OS of patients who received immunotherapy was higher than that of patients who did not receive immunotherapy,and the higher the PD-L1 expression,the longer the median OS.Conclusion:Through the overall analysis of 51 patients with advanced thymic squamous cell carcinoma in our hospital,the combination of platinum and paclitaxel as the first-line treatment regimen has definite efficacy and acceptable safety.For patients with high PD-L1 expression,PD-1 inhibitors can be considered.The incidence of thymus tumors is low,and surgery is the primary treatment in the early stage.However,disease recurrence occurs in 10%to 30%of patients with thymus tumors after R0 resection.For patients with unresectable or recurrent disease,medical treatment,including chemotherapy,targeted therapy and immunotherapy,is the main treatment.In recent years,there has been little progress in the research of chemotherapy for thymus tumors.However,with the in-depth understanding of the molecular pathways and immune escape mechanism of malignant tumors,great breakthroughs have been made in the targeted therapy and immunotherapy of thymus tumors.In order to provide reference for the treatment of advanced thymic tumors,this article reviewed the recent progress in the medical treatment of thymic tumors and analyzed the efficacy and safety of various drugs in the treatment of thymic tumors...