重组人血管内皮抑制素联合放化疗治疗局部晚期鼻咽癌的初步临床研究

Clinical results of recombinant human endostatin combined with chemoradiotherapy for locally advanced nasopharyngeal carcinoma

目的：观察重组人血管内皮抑制素联合诱导化疗序贯同步放化疗治疗局部晚期鼻咽癌的近期疗效、耐受性和安全性。方法2011年12月30日至2013年3月31日，53例局部晚期鼻咽癌患者接受重组人血管内皮抑制素联合诱导化疗序贯同步放化疗治疗（试验组），选取诱导化疗序贯同步放化疗的48例局部晚期鼻咽癌患者为对照组，比较两组患者的近期疗效、生存率、无进展生存率和不良反应。结果治疗结束后3个月，试验组和对照组患者的鼻咽部肿瘤完全缓解（ CR）率分别为77．4％和72．9％，差异无统计学意义（P＝0．154）。试验组和对照组患者的颈部阳性淋巴结CR率分别为75．5％和62．6％，差异有统计学意义（P＝0．037）。试验组和对照组患者的2年生存率分别为82．3％和87．2％，2年无进展生存率分别为77．2％和84．3％，2年无远处转移生存率分别为82．2％和84．2％，差异均无统计学意义（P＝0．938，P＝0．551，P＝0．725）。试验组和对照组患者不良反应比较，差异无统计学意义（P＞0．05）。结论重组人血管内皮抑制素联合诱导化疗序贯同步放化疗治疗局部晚期鼻咽癌的近期有效率高于诱导化疗序贯同步放化疗，同时未增加不良反应，其治疗相关性毒性患者可以耐受。

Objective To compare the short-term efficacy and observe the tolerability and safety of recombinant human endostatin combined with induction chemotherapy followed by chemoradiotherapy for locally advanced nasopharyngeal carcinoma. Methods Fifty-three patients with locally advanced nasopharyngeal carcinoma, who received recombinant human endostatin combined with induction chemotherapy followed by chemoradiotherapy, treated in our department from December 2011 to March 2013 were included in the study group of this study. Another 48 patients, who received induction chemotherapy followed by chemoradiotherapy alone in the same period, were chosen as a control group. The short-term outcome, overall survival （OS）, progression-free survival （PFS）,and acute side effects of the two groups were compared. Results The complete remission rates of nasopharyngeal tumor in the study and control groups were 77. 4% and 72. 9%, respectively （P=0. 154）. The complete remission rates of patients with and without cervical lymph node metastasis were 75. 5% and 62. 6%, respectively, showing a significant difference （P=0. 037）. The 2-year OS, PFS, and DMFS rates for the study group were 82. 3%, 77. 2%, and 82. 2%, respectively, versus 87. 2%, 84. 3% and 84. 2% for the control group, showing a non-significant differences between the two groups （P=0. 938, P=0. 551, and P=0. 725）. Conclusions The short-term results of recombinant human endostatin （ Endostar ） combined with induction chemotherapy followed by concurrent chemoradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma are slightly better than that of induction chemotherapy followed by concurrent chemoradiotherapy alone, with tolerable treatment-related toxicity and no more side effects.