目的 觀察白蛋白結(jié)合型紫杉醇聯(lián)合鉑類藥物及免疫檢查點(diǎn)抑制劑和注射用紫杉醇脂質(zhì)體聯(lián)合鉑類藥物及免疫檢查點(diǎn)抑制劑治療不可手術(shù)切除的局部晚期或轉(zhuǎn)移性肺鱗癌患者的有效性。方法 選擇2020年8月—2022年8月天津市胸科醫(yī)院胸部腫瘤中心收治的59例肺鱗癌患者，按照不同的治療方案分為白蛋白結(jié)合型紫杉醇組（29例）和紫杉醇脂質(zhì)體組（30例）。兩組患者均在化療前靜脈滴注免疫檢查點(diǎn)抑制劑。白蛋白結(jié)合型紫杉醇組患者每療程第1天靜脈滴注注射用紫杉醇（白蛋白結(jié)合型），260 mg/m²，隨后予靜脈滴注鉑類藥物。紫杉醇脂質(zhì)體組患者每療程第1天靜脈滴注注射用紫杉醇脂質(zhì)體，160 mg/m²，隨后靜脈滴注鉑類藥物。兩組鉑類藥物包括注射用順鉑、卡鉑注射液、注射用奈達(dá)鉑，鉑類藥物均為每治療周期第1天給藥。兩組患者均以21 d為一個(gè)化療療程。兩組患者至少完成2個(gè)療程的治療。觀察兩組的臨床療效和不良反應(yīng)發(fā)生情況。結(jié)果 治療后，白蛋白結(jié)合型紫杉醇組和紫杉醇脂質(zhì)體組客觀緩解率（ORR）分別為27.59%、23.33%，疾病控制率（DCR）分別是89.66%、90.00%，兩組ORR、DCR比較差異無(wú)統(tǒng)計(jì)學(xué)意義。白蛋白結(jié)合型紫杉醇組的骨髓抑制發(fā)生例數(shù)顯著低于紫杉醇脂質(zhì)體組，差別有統(tǒng)計(jì)學(xué)意義（P<0.05），紫杉醇脂質(zhì)體組的周圍神經(jīng)毒性發(fā)生例數(shù)顯著低于白蛋白結(jié)合型紫杉醇組，差別有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者脫發(fā)、嘔吐、皮疹、甲狀腺功能異常、肝功能異常的發(fā)生率比較差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 白蛋白結(jié)合型紫杉醇聯(lián)合鉑類藥物及免疫檢查點(diǎn)抑制劑治療方案可以讓不可手術(shù)切除的局部晚期或轉(zhuǎn)移性肺鱗癌患者獲益，能夠幫助臨床醫(yī)師在治療肺鱗癌患者時(shí)提供最佳決策。

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

天津市衛(wèi)生健康委青年人才項(xiàng)目（TJWJ2021QN057）