对于局部晚期胰腺腺癌（LAPC）患者的治疗选择非常有限，化疗疗效也很有限。免疫治疗和放疗是LAPC的潜在有效治疗方法，两种治疗方法都可能与化疗联合起来。因此，在这个前瞻性队列研究中，我们比较了纳布-紫杉醇加吉西他滨联合抗编程细胞死亡（PD-1）免疫治疗和放疗（以下简称联合治疗）与纳布-紫杉醇加吉西他滨（仅化疗）在LAPC治疗中的疗效和安全性。在联合治疗组中，参与者接受了传统分数放疗，剂量范围从54到63Gy，共分28个周期，每3周一次200mg抗PD-1免疫治疗，以及在第1和第8天的21天循环中静脉注射纳布-紫杉醇加吉西他滨八个周期，直到疾病进展、死亡或不可接受的毒性。在化疗组中，参与者在21天循环的第1和第8天接受静脉注射纳布-紫杉醇加吉西他滨八个周期。自2020年4月至2021年12月，共有96名LAPC患者在一个中心进行了前瞻性招募，其中32人接受了联合治疗，64人接受了仅化疗。联合治疗组的中位总生存期（22.3个月 vs. 18.6个月，P = 0.031）和无进展生存期（12.0个月 vs. 10.5个月，P = 0.043）均显著长于仅化疗组。联合治疗组和化疗组的严重不良事件发生率没有显著差异（P = 0.856）。总之，纳布-紫杉醇加吉西他滨联合抗PD-1免疫治疗和放疗对LAPC患者是有效且安全的，值得在更大的随机试验中进一步研究。 ©2023年作者。

Treatment options specifically for patients with locally advanced pancreatic adenocarcinoma (LAPC) are scare and chemotherapy alone delivers limited efficacy. Immunotherapy and radiotherapy are potential effective treatments for LAPC, and both of them may synergize with chemotherapy. Therefore, in this prospective cohort study, we compared the efficacy and safety of nab-paclitaxel plus gemcitabine combined with anti-programmed cell death (PD-1) immunotherapy and radiotherapy (hereafter, combination treatment) versus nab-paclitaxel plus gemcitabine (chemotherapy alone) in the treatment of LAPC. In the combination group, participants received conventional fractionated radiotherapy with doses ranging from 54 to 63 Gy in 28 fractions, intravenous camrelizumab 200 mg once every 3 weeks, and intravenous nab-paclitaxel plus gemcitabine on day 1 and 8 of a 21-day cycle for eight cycles until disease progression, death or unacceptable toxicity. In the chemotherapy group, participants received intravenous nab-paclitaxel plus gemcitabine on day 1 and 8 of a 21-day cycle for eight cycles. From April, 2020 to December, 2021, 96 participants with LAPC were prospectively enrolled with 32 received combination treatment and 64 received chemotherapy alone at a single center. The combination treatment yielded significantly longer median overall-survival (22.3 months vs. 18.6 months, P = 0.031) and progression-free survival (12.0 months vs. 10.5 months, P = 0.043) than chemotherapy alone did. And the incidence of severe adverse events was not significantly different between the combination group and chemotherapy group (P = 0.856). In conclusion, nab-paclitaxel plus gemcitabine combined with anti-PD-1 immunotherapy and radiotherapy was effective and safe for LAPC patients, and it warrants further investigation in larger randomized trials.© 2023. The Author(s).