Immune checkpoint inhibitors (ICIs) can cause myenteric plexopathy, which could result in delayed gastric emptying (GE) and possibly gastroparesis. We assessed the clinical outcomes of patients who had pre-existing gastroparesis or who developed symptoms of delayed GE following ICI therapy. We retrospectively identified adults with ICD-9 and ICD-10 codes for gastroparesis who received ICI therapy between 1 January 2020 and 31 December 2022 at a tertiary cancer center. Of 76 eligible patients, 37 had pre-existing gastroparesis; 39 (0.2% of the more than 18,000 screened) developed symptoms of delayed GE after ICI therapy, of which 27 (69%) patients had an alternative etiology for delayed GE. Four patients (11%) with pre-existing gastroparesis had a flare-up after ICI, and the median time to flare-up was 10.2 months (IQR, 0.7–28.6 months); for patients with new onset of suspected delayed GE after ICI, the median time to symptom onset was 12.8 months (IQR, 4.4–35.5 months). The clinical symptom duration of patients without an alternative etiology (74.5 days (IQR, 21.5–690 days)) and those with an alternative etiology (290 days (IQR, 147–387 days)) did not differ significantly (p= 1.00). Delayed GE after ICI therapy is a rare presentation but has a late onset and a prolonged symptom duration.
免疫检查点抑制剂（ICIs）可引发肠肌丛神经病变，进而导致胃排空延迟，并可能诱发胃轻瘫。本研究评估了在接受ICI治疗前已存在胃轻瘫，或在治疗后出现胃排空延迟症状患者的临床结局。我们回顾性分析了2020年1月1日至2022年12月31日期间，在一家三级癌症中心接受ICI治疗、且具有胃轻瘫ICD-9和ICD-10编码的成年患者。在76例符合条件的患者中，37例为既存胃轻瘫；39例（占筛查的18,000余例患者的0.2%）在ICI治疗后出现胃排空延迟症状，其中27例（69%）患者存在导致胃排空延迟的其他病因。4例（11%）既存胃轻瘫患者在ICI治疗后出现症状急性加重，中位加重时间为10.2个月（四分位距，0.7–28.6个月）；对于ICI治疗后新发疑似胃排空延迟的患者，中位症状出现时间为12.8个月（四分位距，4.4–35.5个月）。无其他病因患者的临床症状持续时间（74.5天（四分位距，21.5–690天））与存在其他病因患者（290天（四分位距，147–387天））无显著差异（p=1.00）。ICI治疗后的胃排空延迟虽属罕见临床表现，但其发病较晚且症状持续时间较长。
肿瘤(癌症)患者之家