贝伐珠单抗联合顺铂和螺旋断层调强放疗治疗局部晚期鼻咽癌的临床试验研究

Bevacizumab plus cisplatin and helical tomotherapy in treatment of locally advanced nasopharyngeal carcinoma

目的评估贝伐珠单抗联合顺铂（DDP）和螺旋断层调强放疗（TOMO）治疗局部晚期鼻咽癌的疗效和毒副作用.方法：收集2014 年12 月 – 2015 年10 月期间30 例经病理验证为Ⅲ~Ⅳ期的鼻咽癌患者（无远处转移）,制定严格的入组和排除标准,给予统一的治疗方案.放疗采用TOMO放疗,总剂量为67.5 Gy/33 F,DDP剂量为80 mg·m^-2（第2、23、44天输入）,贝伐珠单抗剂量为5 mg·kg^-1（第1、15、29、43 天输入）.结果：治疗后3 个月,30 例局部晚期鼻咽癌患者中有24 例（80%）完全缓解,6 例（20%）部分缓解.24 例（80%）患者出现了口腔黏膜炎的毒性反应,其中26%的患者由于口腔黏膜炎引起的咽部疼痛、吞咽困难导致体重减轻,未见其余严重毒副反应.结论：贝伐珠单抗联合DDP和TOMO放疗治疗局部晚期鼻咽癌可提高疗效,并且不会增加不可接受的毒性反应和副作用.

Objective: To evaluate the efficacy and toxicity of bevacizumab combination with cisplatin(DDP) and helical tomotherapy(TOMO) treatment in locally advanced nasopharyngeal carcinoma. Methods: Thirty patients with histologically confirmed stage Ⅲ – Ⅳ(without distant metastasis) nasopharyngeal carcinoma were recruited with strict eligibility requirements and exclusion criteria from December 2014 to October 2015. Bevacizumab 5 mg·kg-1, 80 mg·m-2 DDP and 67.5 Gy/33 F radiotherapy(TOMO) was given accord ing to the standard treatment protocols. Results: After 3 months, 24 complete responses(80%) and six partial responses(20%) were observed in our research. Twenty-four patients(80%) experienced oropharyngeal mucositis, and 26% patients experienced weight loss caused by pharyngeal pain and dysphagia caused by oropharyngeal mucositis. Conclusion: Bevacizumab plus DDP and TOMO in treatment of locally advanced nasopha ryngeal carcinoma can increase curative effects with low side effects and toxicities.