尼妥珠单抗联合同步放化疗治疗局部晚期鼻咽癌的疗效观察

Effect of Nimotuzumab Combined with Concurrent Chemoradiotherapy for Locally Advanced Nasopharyngeal Carcinoma

目的观察尼妥珠单抗联合同步放化疗治疗局部晚期鼻咽癌的安全性和有效性。方法 40例Ⅲ～Ⅳa期初治鼻咽部未分化非角化性癌患者,按就诊单双号分为两组,每组20例。治疗组采用尼妥珠单抗静脉滴注,100 mg.次-1.周-1,连用6～8周;适形调强放疗并同步卡铂+5-氟尿嘧啶(CF)方案化疗2～6周期。对照组采用适形调强放疗同步CF方案化疗,方法同治疗组。采用免疫组化方法检测患者肿瘤组织表皮生长因子受体(EGFR)、原位杂交法检测表皮主长因子受体(EBER)的表达,治疗结束3、6、12个月评价两组的疗效和安全性。结果治疗组和对照组的癌组织表达阳性EGFR率分别为90.0%、100.0%;两组癌组织EBER阳性表达率均为100.0%。EGFR、EBER在两组的表达差异无统计学意义(P>0.05);治疗后3、6个月治疗组疗效均优于对照组(P<0.05);治疗期间两组不良反应严重程度比较,差异均无统计学意义(P>0.05)。结论鼻咽部未分化非角化性癌EGFR阳性表达率高,尼妥珠单抗联合同步放化疗治疗局部晚期鼻咽癌提高了疗效,且未加重同步放化疗的不良反应,患者耐受性好。

Objective To investigate the safety and efficacy of nimotuzumab combined with concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma.Methods Forty untreated cases of III-Ⅳa stage nasopharyngeal undifferentiated non-keratinizing carcinoma were divided into two groups according to their first visit date,20 cases in each group.The treatment group was given nimotuzumab（intravenous infusion of 100mg once a week）,and the treatment lasted for 6-8 weeks;Conformal intensity modulated radiotherapy combined with concurrent CF chemotherapy was performed in the treatment group for 2 to 6 cycles.Conformal intensity modulated radiotherapy combined with CF chemotherapy was performed in the control group,the same as in the treatment group.Immunohistochemistry was used to detect epidermal growth factor receptor（EGFR） in tumor tissues while in situ hybridization assay was used to detect EBER expression.The safety and efficacy of treatment were evaluated 3,6 and 12 months after treatment,respectively.Results The positive rates of EGFR expression in the treatment group and control group were 90.0% and 100.0%,respectively.The positive rate of EBER expression was 100.0% in the two groups.There was no significant difference in the positive rates of EGFR and EBER expression between two groups（P 0.05）.The efficacy of treatment for treatment group was superior to that for control group 3 months after treatment as well as 6 months after treatment（P 0.05）;There was no significant difference in the severity of adverse reaction between two groups during treatment period（P 0.05）.Conclusion The positive rate of EGFR expression in the nasopharyngeal undifferentiated non-keratinizing carcinoma is high.Nimotuzumab combined with concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma can improve the efficacy,its adverse reactions are similar with those of concurrent chemoradiotherapy,and patient tolerance is good.