| 侯俊,冯林春,蔡博宁,路娜,杜镭,马林,徐寿平,解传滨.螺旋断层放疗联合抗表皮生长因子受体单抗治疗鼻咽癌的初步临床观察[J].中华放射医学与防护杂志,2011,31(3):329-332 |
| 螺旋断层放疗联合抗表皮生长因子受体单抗治疗鼻咽癌的初步临床观察 |
| Clinical observation in nasopharyngeal carcinoma (NPC) treated with the anti-EGFR monoclonal antibody followed by helical tomotherapy |
| 投稿时间：2011-01-22 |
| DOI：10.3760/cma.j.issn.0254-5098.2011.03.020 |
| 中文关键词: 螺旋断层放射治疗 鼻咽癌 尼妥珠单克隆抗体 西妥昔单克隆抗体 |
| 英文关键词:Tomotherapy Nasopharyngeal carcinoma Nimotuzumab Cetuximab |
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| 中文摘要: |
| 目的 探讨螺旋断层放疗联合抗EGFR单克隆抗体治疗鼻咽癌的近期疗效和不良反应。方法 回顾性分析2008年3月—2009年11月本科34例行根治性螺旋断层放疗鼻咽癌患者临床资料。鼻咽部肿瘤(pGTVnx)及可见的转移淋巴结(pGTVnd)处方剂量70 Gy/33次,高危区(PTV1)60 Gy/33次,低危区(PTV2)56 Gy/33次,5次/周。其中17例放疗期间联合尼妥珠单抗,200 mg/次,静滴,每周1次,共6~7次(尼妥珠组);另外17例放疗期间联合西妥昔单抗,首次剂量400 mg/m2, 以后每周250 mg/m2,静滴,每周1次,共6~7次(西妥昔组)。参照RECIST 1.0版实体瘤评价标准评价疗效,采用RTOG/EROTC标准评价急性反应。结果 随访时间13~34个月,中位随访时间22个月。放疗后3、6及12个月的有效率(CR+PR),尼妥珠组和西妥昔组分别为14/17和15/17(χ2 =1.00,P=0.00)、12/17和14/17(χ2=0.16,P=0.69)、12/17和14/17(χ2=0.16,P=0.69)。1年生存率尼妥珠组和西妥昔组分别为15/17和17/17(χ2=0.53,P=0.24)。两组近期疗效及1年生存率差异无统计学意义。尼妥珠组急性口腔黏膜反应(u=2.25,P<0.05)、体重下降程度(t=2.56, P=0.02)、皮疹(u=4.36,P<0.01)较西妥昔组轻。结论 螺旋断层放疗联合尼妥珠单抗与联合西妥昔单抗治疗鼻咽癌的近期疗效及1年生存率差异无统计学意义,不良反应尼妥珠较西妥昔轻,但均可耐受。 |
| 英文摘要: |
| Objective To evaluate the clinical outcome and the acute toxicity in nasopharyngeal carcinoma (NPC) treated with tomotherapy followed by the anti-EGFR monoclonal antibody. Methods Between March 2008 and November 2009, 34 newly diagnosed NPC patients were treated with helical tomotherapy combined with nimotuzumab or cetuximab. All the patients underwent tomotherapy at the dose of 70 Gy/33F for the gross tumor volume (pGTVnx) and positive lymphnodes (GTVnd), and 60 Gy/33F for the high risk clinical target volume (PTV1), and 56 Gy/33F for the low risk clinical target volume (PTV2), respectively. 17 patients in group N were given weekly injection of 200 mg for 6-7 times and 17 patients in group C were given initial dosage 400 mg/m2 followed by subsequent weekly dosage of 250 mg/m2 for 6-7 times. Acute lesions were evaluated with the RTOG/EORTC criteria. Result The median follow-up time was 22 months. The effective rates (CR+PR) in 3, 6 and 12 months were 14/17, 12/17, 12/17 in group N and 15/17, 14/17, 14/17 in group C. The 1 year survival rate was 15/17 in group N and 17/17 in group C. Nimotuzumab had less acute mucositis reaction (u=2.25, P<0.05), weight loss (t=2.56, P=0.02) and rash (u=4.36, P<0.01) compared with cetuximab. Conclusions Helical tomotherapy combined with nimotuzumab or cetuximab was effective and made no difference in the short-term efficacy and 1 year survival rate for the patients with NPC. Nimotuzumab has less acute reaction than cetuximab. More studies should be done to prove long-term effects. |
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