ABSTRACT
Objective:To investigate the efficacy and safety of sindilizumab combined with apatinib in the treatment of elderly patients with advanced recurrent and metastatic esophageal squamous cell carcinoma.Methods:A total of 74 elderly patients with recurrent and metastatic esophageal squamous cell carcinoma who were admitted to Xuancheng City Central Hospital from March 2019 to August 2020 were selected, and they were divided into study group and control group by random number table method, with 37 cases in each group. The control group was treated with apatinib mesylate, and the study group was treated with sindilizumab combined with apatinib mesylate. All patients were treated for 2 cycles and followed up for 1 year. The efficacy, peripheral blood tumor marker levels, adverse reactions and survival were compared between the two groups.Results:The objective response rate and clinical control rate in the study group were higher than those in the control group [35.1% (13/37) vs. 13.5% (5/37), 67.6% (25/37) vs. 43.2% (16/37)], and the differences were statistically significant ( χ2 = 4.70, P = 0.030; χ2 = 4.43, P = 0.035). After treatment, the levels of carcinoembryonic antigen (CEA), squamous cell carcinoma-associated antigen (SCC-Ag) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) in the two groups were all lower than those before treatment (all P < 0.05); the levels of CEA, SCC-Ag and CYFRA21-1 in the study group were lower than those in the control group (all P < 0.05). There were no differences in the incidence rates of fatigue, proteinuria, bone marrow suppression, and hand-foot syndrome between the two groups (all P > 0.05). After 1 year of follow-up, 20 patients in the study group survived, and the 1-year overall survival (OS) rate was 54.1%; 10 patients in the control group survived, and the 1-year OS rate was 28.6%; the difference in OS between the two groups was statistically significant ( χ2 = 4.06, P = 0.044). Conclusions:Sintilimab combined with apatinib has a good efficacy in the treatment of elderly patients with advanced recurrent and metastatic esophageal squamous cell carcinoma. This regimen can reduce the levels of tumor markers, improve the short-term survival rate of patients, and has good safety.