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目的:探讨尼妥珠单抗联合同期三维适形放疗(3D-CRT)及化疗治疗Ⅲ、ⅣA期鼻咽癌的疗效及不良反应。方法:经组织病理确诊的Ⅲ、ⅣA期(2008分期)鼻咽癌初诊患者63例随机分为对照组(33例)和治疗组(30例),均采用3D-CRT及同期和序贯紫杉醇顺铂方案化疗,治疗组每周一放疗前行尼妥珠单抗100mg治疗,共6～7次。结果:放疗结束后2个月原发灶CR率、颈部淋巴结CR率治疗组分别为100.0%、96.7%,明显高于对照组的81.8%及75.8%(P均<0.05),放疗后1年局部控制率、无转移生存率在治疗组及对照组分别达到100.0%vs.89.3%、95.5%vs.82.1%(P>0.05),两组主要不良反应为放射性咽喉炎、放射性皮炎和恶心呕吐、白细胞减少、疲乏等,耐受性较好。治疗组发生3度以上放射性咽喉炎(P<0.05)、放射性皮炎(P>0.05)较对照组偏高。结论:尼妥珠单抗联合3D-CRT及紫杉醇及顺铂同期及序贯化疗治疗局部晚期鼻咽癌,可提高近期完全缓解率及局部控制率,耐受性较好,远期生存率有待进一步观察研究。
Objective: To investigate the efficacy and side effects of nimotuzumab combined with three-dimensional conformal radiotherapy (3D-CRT) and chemotherapy for stage Ⅲ and ⅣA nasopharyngeal carcinoma. Methods: Sixty-three patients with newly diagnosed nasopharyngeal carcinoma diagnosed by histopathology were randomly divided into control group (n = 33) and treatment group (n = 30). All patients were treated with 3D-CRT and concurrent and sequential paclitaxel Cisplatin chemotherapy, the treatment group nimotuzumab 100mg per week before radiotherapy, a total of 6 to 7 times. Results: At 2 months after the end of radiotherapy, CR rate and CR rate in cervical lymph nodes were 100.0% and 96.7% respectively, which were significantly higher than 81.8% and 75.8% in control group (all P <0.05) The rates of local control and non-metastasis in the two groups were 100.0% vs.89.3% and 95.5% vs.82.1% (P> 0.05) respectively in the treatment group and the control group. The main adverse reactions were radiation laryngitis, radiodermatitis and nausea Vomiting, leukopenia, fatigue, etc., better tolerated. The treatment group had more than 3 degrees radiation laryngitis (P <0.05), radiodermatitis (P> 0.05) higher than the control group. Conclusion: Both nimotuzumab combined with 3D-CRT, paclitaxel and cisplatin concurrent and sequential chemotherapy in the treatment of locally advanced nasopharyngeal carcinoma can improve the recent complete remission rate and local control rate, the tolerance is good, long-term survival rate to be Further observation and research.