局部晚期鼻咽癌EGFR单抗诱导治疗疗效与EGFR表达的相关性

Correlation between efficacy of the induction therapy combined with EGFR monoclonal antibody and the expression level of EGFR in locally advanced nasopharyngeal carcinoma

目的:通过对照研究,探讨局部晚期鼻咽癌患者的EGFR表达水平与联合EGFR单抗诱导治疗疗效的相关性。方法:118例来自“尼妥珠单抗、顺铂、5-氟尿嘧啶诱导化疗后顺铂同期调强放射治疗局部晚期鼻咽癌多中心前瞻性随机对照研究”的病例,通过免疫组化检测EGFR表达水平。其中,尼妥珠单抗联合顺铂、5-氟尿嘧啶方案诱导治疗组(NPF组)58例,多西他赛、顺铂、5-氟尿嘧啶方案诱导化疗组(TPF组)60例。比较两组EGFR表达情况与诱导治疗疗效相关性。结果:全组EGFR表达率为94.9%;EGFR表达与性别、临床分期等临床特征无显著相关(P>0.05)。EGFR表达水平与TPF诱导化疗的疗效无显著相关(P=0.090),但显著影响联合尼妥珠单抗的诱导治疗疗效(P=0.015);与TPF化疗比较,EGFR高表达水平患者接受联合EGFR单抗的诱导治疗有更好的治疗反应(P=0.033)。结论:在局部晚期鼻咽癌中,EGFR的表达水平与联合EGFR单抗诱导治疗的疗效密切相关;对于EGFR高水平表达的患者,增加EGFR单抗可能提高诱导治疗的临床获益。

Objective:The correlation between the level of EGFR expression and the induction therapy of combined EGFR monoclonal antibody in locally advanced nasopharyngeal carcinoma was discussed through a controlled study.Methods:The expression level of EGFR was detected by immunohistochemistry in 118 cases from"nituzumab,cisplatin,5-fluorouracil induced chemotherapy and cisplatin combined with simultaneous intensity modulated radiotherapy in the treatment of locally advanced nasopharyngeal carcinoma in a multi-center prospective randomized controlled study",including 58 cases in NPF group(induction therapy of nimotuzumab combined with PF regimen)and 60 cases in TPF group(induction chemotherapy of docetaxel,cisplatin and fluorouracil regimen).The correlation between the expression of EGFR and the curative effect of induction therapy was compared between the two groups.Results:The expression rate of EGFR was 94.9%in the whole group of patients.There was no significant correlation between EGFR expression and gender,clinical staging and other clinical features(P>0.05).The expression level of EGFR was not significantly correlated with the curative effect of TPF induced chemotherapy(P=0.090),but significantly affected the efficacy of the induction therapy combined with nituzumab(P=0.015).Compared with TPF induction chemotherapy,patients with high expression level of EGFR had a better therapeutic response for the induction treatment of combined EGFR monoclonal antibody(P=0.033).Conclusion:In locally advanced nasopharyngeal carcinoma,the level of EGFR expression is closely related to the curative effect of the induction therapy combined wtih EGFR monoclonal antibody.For patients with high levels of EGFR expression,combined wtih EGFR monoclonal antibody can improve the clinical benefits of induction therapy.