西妥昔单抗联合同步放化疗治疗复发性鼻咽癌的疗效分析

Curative effects of cetuximab combined with concurrent chemo-and radiotherapy on recurrent nasopharyngeal carcinoma

目的探讨西妥昔单抗联合三维适形(3DCRT)同步放化疗对复发性鼻咽癌(NPC)的近、远期疗效及其毒副作用。方法对照组采用顺铂及同步3DCRT放射治疗,放疗:2 Gy/次,5次/w,治疗6～7 w,总剂量为64～68 Gy;同期化疗:在放疗期间予顺铂(20 mg/m2,d 1～4)同期全身化疗2个疗程,每3 w为1疗程。实验组在对照组放化疗基础上加用西妥昔单抗治疗:放疗第1 d开始用西妥昔单抗100 mg加生理盐水250 ml静脉滴注,输液时间不少于60 min,1次/w,共7次。观察比较两组的疗效及不良反应等。结果近期疗效实验组和对照组的总有效率分别为67.65%和50.00%,治疗控制率(DCR)为88.24%和76.47%;远期疗效实验组和对照组总有效率分别为73.53%和58.82%,DCR为91.18%和73.53%,实验组的近、远期疗效均优于对照组。西妥昔单抗未增加放化疗相关的副作用。结论西妥昔单抗联合3DCRT同步放化疗治疗复发性NPC疗效尚可,药物不良反应少,是NPC可行的治疗方法。

Objective To explore the short and long term curative and adverse effects of cetuximab combined with threedimensional conformal concurrent chemo-and radiotherapy（ 3DCRT） on recurrent nasopharyngeal carcinoma（NPC）. Methods Control group were treated with cisplatin and concurrent 3DCRT. They received the total radiotherapy dose of 64-68 Gy with 2 Gy per time and 4 times per week for 6 to 7 weeks. They also received the concurrent chemotherapy with eisplatin（20 mg,/m2 from d 1-4） for 2 courses of treatment, and 3 weeks was a course of treatment. Based on those treatments above, the experimental group also received the treatment with cetuximab. From the first day of radiotherapy, they received the intravenous drip with 100 mg eetuximab and 250 ml sodium chloride for more than 60 minutes once per week and totally 7 times. Comparison was made in the curative and adverse effect between the two groups. Results The total effective rate of short term curative effects in the experimental and control group was 67.65% and 50.00% ,respectively;the treatment control rate （TCR）was 88.24% and 76.47% , respectively. The total effective rate of long term curative effect in the experimental and control group was 73.53% and 58.82%, respectively; the TCR was 91.18% and 73.53%, respectively. The short and long term curative effects of the experimental group were all better than those of the control group. Cetuximab did not significantly increase the side effects related to radiotherapy and chemotherapy. Conclusion Cetuximab combined with 3DCRT concurrent chemo-and radiotherapy has acceptable curative effects on recurrent NPC with fewer drug adverse effects, which is a feasible treatment method for NPC.