放射性粒子置入联合尼妥珠单抗治疗牙龈癌的临床效果

Clinical effect of radionuclide implantation combined with Nituzumab in the treatment of gingival cancer

目的探讨放射性粒子置入联合尼妥珠单抗治疗牙龈癌的临床效果。方法回顾性选取2016年1月至2018年1月在唐山市协和医院接受治疗的66例牙龈癌患者,根据治疗方法的不同,分为对照组和研究组,每组各33例。对照组采取单一的放射性粒子置入的医治方法,研究组采用放射性粒子置入联合尼妥珠单抗的医治方法。比较两组患者治疗7天、14天疼痛缓解情况和Karnofsky评分,治疗前后病灶大小,临床疗效,不良反应的发生情况以及各项治疗相关指标。结果治疗前,研究组VAS评分为(6.7±1.2)分,Karnofsky评分为(35.7±6.3)分,对照组组VAS评分为(6.6±1.9)分,Karnofsky评分为(36.8±4.8)分,两组患者的VAS评分及Karnofsky评分差异无统计学意义(P>0.05);治疗后7 d、14 d研究组VAS评分为(3.8±1.6)分、(1.8±1.4)分,显著低于对照组的(4.3±1.5)分、(2.9±1.2)分(P<0.05);研究组Karnofsky评分为(65.9±3.9)分、(86.9±5.2)分,显著高于对照组的(56.8±7.4)分、(72.4±4.6)分(P<0.05)。治疗前,研究组患者的病灶大小较对照组患者的病灶大小差异无统计学意义(P>0.05);研究组治疗后1个月、治疗后3个月以及治疗后半年的病灶大小为(3.5±1.8)mm、(3.2±2.2)mm、(2.9±1.3)mm,均明显低于对照组的病灶大小(4.6±1.9)mm、(4.0±1.5)mm、(3.4±1.6)mm(P<0.05)。研究组的总有效率为75.8%,对照组的总有效率为45.5%,研究组临床过程中的疗效明显优于对照组(P<0.05)。不良反应方面,研究组的发生率为21.2%,对照组的发生率为54.5%,研究组不良反应的发生情况明显低于对照组(P<0.05);研究组的各项治疗相关指标均明显优于对照组(P<0.05)。结论在医治牙龈癌的过程中,与单一的放射性粒子置入治疗相比,使用放射性粒子置入联合尼妥珠单抗的医治方法能明显缓解疼痛,缩小病灶,改善临床治疗的各项指标,提高临床疗效,并降低不良反应发生率,为临床治疗牙龈癌患者提供新的治疗思路。

Objective To explore the clinical effect of radionuclide injection combined with nituzumab in the treatment of gingival carcinoma.Methods A retrospective study was performed on 66 patients with gum cancer who received treatment from January 2016 to January 2018 in Xiehe hospital of Tangshan city,Hebei province.The control group was treated with a single radioactive seed implantation,while the study group was treated with a combination of nituzumab and radioactive particles implantation.The pain relief and Karnofsky scores at 7 and 14 days after treatment were compared between the two groups,the lesion size,clinical efficacy,occurrence of adverse reactions and related indicators before and after treatment.Results Before treatment,VAS score(6.7±1.2),Karnofsky score(35.7±6.3),VAS score(6.6±1.9)and Karnofsky score(36.8±4.8)were not statistically significantly different(P>0.05).At 7 and 14 days,VAS score(3.8±1.6)and(1.8±1.4)in the study group were significantly lower than those of the control group(4.3±1.5)and(2.9±1.2)(P<0.05).The Karnofsky scores of the study group were(65.9±3.9),(86.9±5.2),significantly higher than those of the control group(56.8±7.4)and(72.4±4.6)(P<0.05).Before treatment,there was no statistically significant difference in lesion size between the study group and the control group(P>0.05).The size of lesions in the study group 1 month after treatment,3 months after treatment and 6 months after treatment were(3.5±1.8)mm,(3.2±2.2)mm,(2.9±1.3)mm,all of which were significantly lower than those in the control group(4.6±1.9)mm,(4.0±1.5)mm,(3.4±1.6)mm(P<0.05).The total effective rate of the study group was 75.8%,and that of the control group was 45.5%,and the clinical effect of the study group was significantly better than that of the control group(P<0.05).In terms of adverse reactions,the incidence rate of the study group was 21.2%,while that of the control group was 54.5%.The occurrence rate of adverse reactions in the study group was significantly lower than that of the control group(P<0.05).All the therapeutic indicators in the study group were significantly better than those in the control group(P<0.05).Conclusion In the process of treatment of gingival cancer,compared with the single radioactive particle implantation therapy,the use of radioactive particle implantation combined with Nituzumab can significantly alleviate pain,reduce the focus,improve the clinical treatment indicators,improve clinical efficacy,and reduce the incidence of adverse reactions for clinical treatment of gingival cancer.Cancer patients provide new treatment ideas.