Clinical effects of simultaneous radiotherapy combined with karelizumab intravenous infusion after glioma resection

GAO Yu; YAN Wenming; WANG Hongwei; QIN Xiaoling; ZHANG Rutao; GUO Qiwei; LIU Fuyi; DONG Yubo; ZHANG Weihan

doi:10.3969/j.issn.1002-266X.2025.01.006

Abstract：Objective To investigate the clinical effects of simultaneous radiotherapy combined with karelizumab in-travenous infusion after glioma resection.Methods Seventy patients with glioma were selected and randomly divided in-to the observation group and control group,with 35 cases in each group.All glioma patients underwent surgical resection,and patients in the control group received radiotherapy and temozolomide chemotherapy 2-6 weeks after surgery.Patients in the observation group received PD-1 inhibitor karelizumab combined with radiotherapy and concurrent temozolomide chemotherapy 2-6 weeks after surgery.At the end of treatment,we evaluated the recent efficacy,calculated disease con-trol rate(DCR)and objective response rate(ORR).Before and after treatment,peripheral venous blood was collected and serum epidermal growth factor(EGF)and vascular endothelial growth factor(VEGF)were detected using the bio-chemical analyzer.We used flow cytometry to detect peripheral blood CD3+and CD4+T lymphocyte subsets,and calculated CD4+/CD8+.We recorded the adverse reactions during the two treatment periods,including nausea and vomiting,abdomi-nal pain and diarrhea,hypertension,positive urine protein,and decreased white blood cell(WBC),platelet(PTL),and neutrophil(ANC)counts.After chemotherapy,the Karnofsky functional status(KPS)score was used to evaluate the pa-tients' quality of life.A follow-up period of 2 years was conducted,and we recorded the overall survival(OS)and progres-sion-free survival(PFS).Results The DCRs of the observation group and the control group were 65.71％and 40.00％,respectively.The ORRs were 11.43％and 2.86％,respectively.The DCR of the observation group was higher than that of the control group(P<0.05),and there was no statistically significant difference in ORR between the two groups.Serum EGF and VEGF levels significantly decreased in both groups,while peripheral blood CD3+,CD4+T lymphocyte subsets and CD4+/CD8+significantly increased,and the changes were more significant in the observation group after treatment(all P<0.05).There were no significant differences in the incidences of nausea and vomiting,abdominal pain and diarrhea,hypertension,positive urinary protein or the total incidences of decreased WBC,PTL and ANC count between the two groups during treatment(all P>0.05).KPS score,OS and PFS in the observation group were higher than those in the con-trol group(all P<0.05).After 2 years of follow-up,the overall survival rates of the observation group and the control group were 65.71％and 40.00％,respectively,and the overall survival rate of the observation group was higher than that of the control group(P<0.05).Conclusion Synchronous radiotherapy combined with karelizumab after glioma resection dem-onstrated synergistic inhibitory effects in glioma treatment,which could significantly improve the therapeutic efficacy and quality of survival,and enhance the body's immune function and inhibit tumour progression.