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目的评价老年中晚期鼻咽癌患者应用尼妥珠单抗联合放疗及诱导化疗治疗的临床疗效和安全性。方法将42例老年中晚期鼻咽癌患者随机分为两组,一组为尼妥珠单抗联合治疗组(试验组),另一组为放化疗治疗对照组(对照组)。试验组给予顺铂联合5-氟尿嘧啶(5-fluorouracil,5-Fu)诱导化疗后行放疗治疗,放疗期间加用尼妥珠单抗;对照组给予顺铂联合5Fu诱导化疗后行放疗治疗,两组进行疗效及不良反应比较。结果治疗结束后3个月,总有效数试验组19例,占95.0%,对照组15例,占68.2%,两组差异有统计学意义。治疗结束2年后,总有效数试验组17例,占85.0%,对照组15例,占68.2%,差异无统计学意义。KPS评分的增加值试验组要高于对照组,差异有统计学意义。3年总生存率及无瘤生存率,试验组较对照组高,差异无统计学意义。两组均出现了一定程度的不良反应,但差异无统计学意义。结论老年中晚期鼻咽癌患者在顺铂联合5Fu的诱导化疗而后放疗的基础上,联合尼妥珠单抗可改善近期疗效,增加生活质量,同时耐受性好,不良反应可控,远期疗效仍需进一步观察。
Objective To evaluate the clinical efficacy and safety of nimotuzumab combined with radiotherapy and induction chemotherapy in elderly patients with advanced nasopharyngeal carcinoma. Methods Forty-two elderly patients with advanced nasopharyngeal carcinoma were randomly divided into two groups. One was nimotuzumab combined treatment group (experimental group), the other was radiotherapy and chemotherapy treatment control group (control group). The experimental group was given cisplatin combined with 5-fluorouracil (5-Fu) induction chemotherapy after radiotherapy, nimotuzumab during radiotherapy; control group given cisplatin combined with 5Fu chemotherapy after radiotherapy and treatment, two Group for efficacy and adverse reactions comparison. Results 3 months after the end of treatment, the total effective number of test group 19 cases, accounting for 95.0%, 15 cases of control group, accounting for 68.2%, the difference between the two groups was statistically significant. Two years after the end of treatment, the total effective number of test group 17 cases, accounting for 85.0%, 15 cases of the control group, accounting for 68.2%, the difference was not statistically significant. The added value of KPS score test group than the control group, the difference was statistically significant. 3-year overall survival rate and tumor-free survival rate, the experimental group than the control group, the difference was not statistically significant. There was a certain degree of adverse reactions in both groups, but the difference was not statistically significant. Conclusion In elderly patients with advanced nasopharyngeal carcinoma, cisplatin combined with 5Fu induced chemotherapy and radiotherapy, combined with nimotuzumab can improve the short-term efficacy and improve quality of life, while good tolerance, adverse reactions can be controlled, long-term Efficacy still needs further observation.