Clinical efficacy of Triprilimab combined with chemoradiotherapy in the treatment of nasopharyngeal carcinoma with cervical lymph node metastasis and its effect on PTX3 and CYFRA21-1 levels

FEI Xu-mao; JIANG Chao-yang; XU Tao

doi:10.13820/j.cnki.gdyx.20231425

Abstract：Objective To evaluate the clinical efficacy of triprilimab combined with chemoradiotherapy in pa-tients with nasopharyngeal carcinoma and cervical lymph node metastasis and its impact on the levels of pentraxin 3(PTX3)and cytokeratin 19 fragment antigen 21-1(CYFRA21-1).Methods A total of 95 patients with nasopharyn-geal carcinoma and cervical lymph node metastasis treated at the Cancer Department of the Western Theater General Hos-pital of the People's Liberation Army from June 2021 to June 2022 were selected.They were randomly divided into an ob-servation group(48 cases)and a control group(47 cases).The control group received routine chemoradiotherapy,while the observation group received additional triprilimab,with both groups undergoing three cycles of treatment.The efficacy of the two groups was compared,and serum levels of PTX3,CYFRA21-1,interferon-γ(IFN-γ),tumor necrosis fac-tor-α(TNF-α),and T lymphocyte levels were measured before and after treatment.The incidence of adverse events during treatment was also recorded.Progression-free survival(PFS)was assessed through follow-up until March 31,2023.Results The objective response rate(ORR)of the nasopharyngeal primary lesion and cervical lymph nodes in the observation group was higher than that in the control group(P＜0.05).After treatment,the serum levels of PTX3 and CYFRA21-1 in both groups decreased compared to before treatment,and the observation group was lower than the control group(P＜0.05).Post-treatment,the observation group showed higher serum levels of IFN-γ,TNF-α,CD3+,CD4+,and CD8+compared to pre-treatment,and these levels were higher than those in the control group(P＜0.05).There were no statistically significant differences in the incidence of gastrointestinal reactions,oral mucositis,radiation dermatitis,leukopenia,neutropenia,thrombocytopenia,liver and kidney function damage,fatigue,and anemia between the two groups(P＞0.05).Patients with high levels of serum PTX3 and CYFRA21-1 had a shorter PFS than those with low levels(P＜0.05).Conclusion Triprilimab combined with chemoradiotherapy demonstrates significant clinical effi-cacy in the treatment of nasopharyngeal carcinoma with cervical lymph node metastasis.This approach effectively reduces serum PTX3 and CYFRA21-1 levels,enhances IFN-γ,TNF-α,and T lymphocyte levels,and maintains a satisfacto-ry safety profile.