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[目的]研究西妥昔单抗联合调强放疗及TP方案化疗治疗局部晚期鼻咽癌的近期疗效及不良反应。[方法]21例局部区域晚期鼻咽癌患者接受调强放射治疗及TP方案同步化疗2个周期,同时接受每周1次的西妥昔单抗治疗。采用CTCAE3.0记录治疗期间的最大不良反应;观察局部区域控制及远处转移情况。[结果]21例患者都完成预定调强放射治疗计划,20例(95.2%)患者完成了预定的西妥昔单抗治疗,19例(90.5%)患者完成了2个周期的TP方案化疗。无治疗相关性死亡发生,4级不良反应包括白细胞减少(7例,33.4%),中性粒细胞减少(3例,14.3%),血小板减少(1例,4.8%)及4级唑疮样皮疹(1例,4.8%)。口腔及口咽黏膜炎、骨髓抑制、放射性皮炎、呕吐为常见的3级毒性。中位随访13个月,21例患者1年局部控制率、区域控制率及无远处转移生存率为100.0%、100.0%及95.2%。[结论]西妥昔单抗联合调强放疗及TP方案化疗治疗局部晚期鼻咽癌近期疗效令人鼓舞,不良反应可控可逆。
[Objective] To study the short-term curative effect and adverse reaction of cetuximab in combination with IMRT and TP regimen in the treatment of locally advanced nasopharyngeal carcinoma. [Method] Twenty-one patients with advanced nasopharyngeal carcinoma in local area underwent two cycles of IMRT and TP regimen and concurrent weekly cetuximab treatment. CTCAE3.0 recorded the maximum adverse reaction during treatment; observation of local control and distant metastasis. [Results] Twenty-one patients (95.2%) completed the planned cetuximab treatment, and 19 (90.5%) completed the two cycles of TP regimen. Grade 4 adverse events included leukopenia (7 cases, 33.4%), neutropenia (3 cases, 14.3%), thrombocytopenia (1 case, 4.8%), and grade 4 azole-like Rash (1 case, 4.8%). Oral and oropharyngeal mucositis, myelosuppression, radiation dermatitis, vomiting are common grade 3 toxicities. After a median follow-up of 13 months, the 1-year local control rate, regional control rate and distant metastasis-free survival rate were 100.0%, 100.0% and 95.2% in 21 patients. [Conclusion] The recent curative effect of cetuximab in combination with IMRT and TP regimen in the treatment of locally advanced nasopharyngeal carcinoma is encouraging. The adverse reactions are controllable and reversible.