Objective To investigate the effect of toripalimab combined with chemoradiotherapy in patients with cervical lymph node metastasis of nasopharyngeal carcinoma on immune function.

Methods A prospective study was conducted in 160 patients with nasopharyngeal carcinoma accompanied by cervical lymph node metastasis. Patients were divided into study group and control group using block randomization, with 80 patients in each group. The control group received a standard chemoradiotherapy regimen, while the study group received toripalimab combined with chemoradiotherapy. Both groups were treated for 3 courses. The clinical efficacy, levels of immune function indicators, levels of tumor markerssquamous cell carcinoma antigen (SCC-Ag), high-mobility group box 1 (HMGB1), pentraxin 3 (PTX3), and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), and the incidenceof adverse reactions were compared between the two groups.

Results The objective response rates of the primary lesion and cervical lymph nodes in the study group were higher than those in the control group (P < 0.05). After treatment, the levels of CD3⁺, CD4⁺, and natural killer cells in the study group were higher than those before treatment and in the control group, while the level of CD8⁺ was lower than that before treatment and in the control group (P < 0.05). After treatment, the levels of HMGB1, PTX3, SCC-Ag and CYFRA21-1 in the study group were lower than those before treatment and in the control group, and the differences were statistically significant (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion Toripalimab combined with chemoradiotherapy has a significant efficacy in treatment of cervical lymph node metastasis of nasopharyngeal carcinoma. It can enhance the immune function of patients, improve the levels of tumor markers, and has good safety.