目的 观察白蛋白结合型紫杉醇联合铂类药物及免疫检查点抑制剂和注射用紫杉醇脂质体联合铂类药物及免疫检查点抑制剂治疗不可手术切除的局部晚期或转移性肺鳞癌患者的有效性。方法 选择2020年8月—2022年8月天津市胸科医院胸部肿瘤中心收治的59例肺鳞癌患者，按照不同的治疗方案分为白蛋白结合型紫杉醇组（29例）和紫杉醇脂质体组（30例）。两组患者均在化疗前静脉滴注免疫检查点抑制剂。白蛋白结合型紫杉醇组患者每疗程第1天静脉滴注注射用紫杉醇（白蛋白结合型），260 mg/m²，随后予静脉滴注铂类药物。紫杉醇脂质体组患者每疗程第1天静脉滴注注射用紫杉醇脂质体，160 mg/m²，随后静脉滴注铂类药物。两组铂类药物包括注射用顺铂、卡铂注射液、注射用奈达铂，铂类药物均为每治疗周期第1天给药。两组患者均以21 d为一个化疗疗程。两组患者至少完成2个疗程的治疗。观察两组的临床疗效和不良反应发生情况。结果 治疗后，白蛋白结合型紫杉醇组和紫杉醇脂质体组客观缓解率（ORR）分别为27.59%、23.33%，疾病控制率（DCR）分别是89.66%、90.00%，两组ORR、DCR比较差异无统计学意义。白蛋白结合型紫杉醇组的骨髓抑制发生例数显著低于紫杉醇脂质体组，差别有统计学意义（P<0.05），紫杉醇脂质体组的周围神经毒性发生例数显著低于白蛋白结合型紫杉醇组，差别有统计学意义（P<0.05）。两组患者脱发、呕吐、皮疹、甲状腺功能异常、肝功能异常的发生率比较差异无统计学意义。结论 白蛋白结合型紫杉醇联合铂类药物及免疫检查点抑制剂治疗方案可以让不可手术切除的局部晚期或转移性肺鳞癌患者获益，能够帮助临床医师在治疗肺鳞癌患者时提供最佳决策。

Objective To observe the efficacy of albumin-binding paclitaxel combined with platinum drugs, immune checkpoint inhibitors and paclitaxel liposome for injection combined with platinum drugs, immune checkpoint inhibitors in the treatment of patients with locally advanced or metastatic lung squamous cell carcinoma that is inoperable. Methods Fifty-nine patients with lung squamous cell carcinoma admitted to the Thoracic Cancer Center of Tianjin Chest Hospital from August 2020 to August 2022 were selected and divided into albumin-binding paclitaxel group (29 cases) and paclitaxel liposome group (30 cases) according to different treatment plans. Both groups were given intravenous immune checkpoint inhibitors before chemotherapy. Patients in albumin-binding paclitaxel group were iv administered with Paclitaxel for injection (Albumin Bound), 260 mg/m², on the first day of each course, followed by intravenous platium drugs. Patients in paclitaxel liposome group were iv administered with Paclitaxel Liposome for injection, 160 mg/m², on the first day of each course, followed by intravenous platinum drugs, including Cisplatin for injection, Carboplatin Injection and Nedaplatin for injection. Platinum drugs were given on the first day of each treatment cycle. Two groups of patients were treated for 21 d of chemotherapy. Patients in both groups completed at least 2 courses of treatment. The clinical efficacy and the occurrence of adverse reactions were observed in the two groups. Result After treatment, the objective response rates (ORR) of the albumin-binding paclitaxel group and the paclitaxel liposome group were 27.59% and 23.33%, respectively, and the disease control rates (DCR) were 89.66% and 90.00%, respectively. There was no statistical significance in ORR and DCR between the two groups. The number of myelosuppression cases in the albumin-binding paclitaxel group was significantly lower than that in the paclitaxel liposome group, with statistical significance (P < 0.05), and the number of peripheral neurotoxicity cases in the paclitaxel liposome group was significantly lower than that in the albumin-binding paclitaxel group, with statistical significance (P < 0.05). There was no significant difference in the incidence of alopecia, vomiting, rash, abnormal thyroid function and abnormal liver function between the two groups. Conclusion Patients with locally advanced or metastatic lung squamous cell carcinoma that is inoperable can benefit from a regimen of albumin-binding paclitaxel combination with platinum drugs and immune checkpoint inhibitors, helping clinicians make optimal decisions in treating patients with lung squamous cell carcinoma.

R979.1

天津市卫生健康委青年人才项目（TJWJ2021QN057）