西妥昔单抗联合术后同步放化疗治疗晚期复发性头颈癌的初步观察

Clinical study of cetuximab combined with post-operative concurrent chemo-radiotherapy on recurrent advanced squamous cell carcinoma of the head and neck

目的评价西妥昔单抗联合术后同步放化疗治疗晚期复发性喉癌及下咽癌患者的近期疗效和不良反应。方法晚期复发性头颈癌患者6例,其中喉复发癌2例,下咽复发癌1例,下咽癌伴肺转移1例,气管造瘘口复发癌2例。分别予以手术治疗后3周,西妥昔单抗与同步放化疗,用法:西妥昔单抗第1周初始剂量为400mg/m2,以后每周维持剂量为250mg/m2,共3周。所有患者均采用直线加速器放疗,常规分割调强放疗,总剂量60Gy,6周完成。在放疗的同时给予化疗,方案是:DDP80mg/m2/d1,5-Fu800mg/m2,120h持续化疗泵静滴。化疗1次/3周,共3次。结果所有患者均顺利完成治疗计划。西妥昔单抗主要不良反应为皮疹、口腔炎、疲乏等。中位随访10个月,病例均存活且肿瘤无进展,未发生远处转移。结论西妥昔单抗联合术后同步放化疗治疗晚期复发性头颈癌安全有效,治疗计划顺利进行,尚需进行进一步临床试验研究。

Objective To evaluate the clinical efficacy of cetuximab combined with concurrent chemo-radiotherapy on recurrent advanced squamous cell carcinoma of the head and neck. Methods 6 patients with recurrent advanced head and neck carcinoma,including 2 larnyngeal carcinoma,1 hypopharyngeal carcinoma,1 hypopharyngeal carcinoma with lung metastasis and 2 stomal recurrence,were treated with cetuximab combined with postoperative radiotherapy and chemotherapy. Cetuximab was administered at an initial dose of 400 mg/m2 in the first week followed by weekly injection of 250 mg/m2. All the patients received a total dose of 60 Gyradiation（2 Gy per fraction,5 fractions per week ） and concurrent chemotherapy（cisplatin 80 mg/m2 d1 and 5-Fu 800 mg/m2 per week with 120 hour continuous intravenous injection）. Results All the patients completed the designated treatment. The primary side effects consisted of acne-like rash,stomatitis,and asthenia. All patients survived after 10 months of median follow-up time,and no progression and metastasis occurred. Conclusion Cetuximab combined with post-operative concurrent chemoradiotherapy is efficient and safe for the management of recurrent advanced carcinoma of head and neck,however,a further large-scale clinical trial is necessary.