Safety And Efficacy Of PD-1 Monoclonal Antibody Combined With Chemoradiotherapy In Locally Advanced Head And Neck Squamous Cell Carcinoma

Objective:To analyze the safety and efficacy of PD-1 monoclonal antibody combined with chemoradiotherapy in locally advanced head and neck squamous cell carcinoma(LAHNSCC).Method:A total of 79 patients with locally advanced head and neck squamous cell carcinoma admitted to the cancer center of our hospital from November 2021 to February 2023 were collected.32 patients with locally advanced head and neck squamous cell carcinoma(LAHNSCC)who received PD-1 monoclonal antibody combined with chemoradiotherapy were included into the study group.According to the principle of consistent disease type,stage,gender and age,47 LAHNSCC patients without PD-1 inhibitor during the same period of chemoradiotherapy were selected as the control group.The efficacy and acute adverse reactions of the two groups were compared,and prognostic factors were analyzed.Objective response rate(ORR)and progression-free survival(PFS)were calculated.Differences between groups were tested by Log-rank method.The COX proportional risk model was used to analyze the prognostic factors.Results:The effective rates of the study group and the control group were 88.67%and 71.88%respectively(χ~2=2.025,P=0.155).The half-year progression-free survival rates of the two groups were 100%and 97.87%,respectively(χ~2=0.020,P=0.087).The incidence of thyroid dysfunction in the study group was higher than that in the control group(28.13%:2.13%,χ~2=9.866 P=0.002),and the incidence of pituitary dysfunction was also increased(12.5%:0%,χ~2=9.537,P=0.002).Multivariate prognostic analysis showed that EGFR and ECOG were the influencing factors of ORR.Conclusions:In this paper,the efficacy and safety of PD-1 monoclonal antibody combined with chemoradiotherapy in LAHNSCC were analyzed.Compared with the chemotherapy group,the treatment scheme combined with PD-1 monoclonal antibody resulted in thyroid and pituitary function abnormalities in patients to a certain extent,and no obvious benefits were seen in short-term efficacy ORR and 6m-PFS.