同步加量放化疗联合尼妥珠单抗治疗不可手术的局部晚期食管鳞癌疗效观察

Efficiency of chemotherapy concurrent with SIB-IMRT plus nimotuzumabin in treatment of unresectable local-advanced esophageal squamous cell carcinoma

目的探索同步加量放化疗联合尼妥珠单抗治疗不可手术的局部晚期食管鳞癌的疗效及安全性。方法对2013年5月至2018年12月就诊于中国科学院大学附属肿瘤医院的52例不可手术的局部晚期食管鳞癌患者采取同步加量放化疗联合尼妥珠单抗治疗,评估治疗结束后1个月疗效,分析末次随访时生存情况、肿瘤复发转移情况,以及治疗期间急性毒性反应发生情况。结果52例患者均完成治疗,中位随访时间30个月。治疗结束后1个月肿瘤客观缓解率为53.8%,疾病控制率为98.1%。末次随访时死亡30例,中位总生存期为33个月,1、3、5年生存率为84.6%、47.1%、39.8%;中位无进展生存期为17个月。治疗期间出现Ⅰ~Ⅱ度放射性食管炎41例,Ⅲ度放射性食管炎11例。结论对于不可手术的局部晚期食管鳞癌患者,同步加量放化疗联用尼妥珠单抗有助于提高5年生存率,且不增加毒性反应。

Objective To evaluate the efficacy and safety of chemotherapy concurrent with simultaneous integrated boost intensity-modulated radiotherapy(SIB-IMRT)combined with nimotuzumab in treatment of unresectable local-advanced esophageal squamous cell carcinoma.Methods Clinical data of 52 eligible esophageal cancer patients in Zhejiang cancer hospital from May 2013 to December 2018 were retrospectively reviewed.The short-term efficacy,survival,tumor recurrence and metastasis,and adverse events during treatment were analyzed.Results Fifty-two patients went through the treatment,with a median follow up time of 30 months.For short-term efficacy the objective response rate was 53.8%and local control rate was 98.1%.The median follow up time was 30 months,30 patients died,the median overall survival was 33 months.The long-term efficacy evaluation showed that the 1 year-,3 year-and 5 year-overall survival rates were 84.6%,47.1%and 39.8%,respectively.The median progression-free survival was 17 months.The main toxic reaction was radiation esophagitis,and 41 patients hadⅠ-Ⅱdegree radiation esophagitis and 11 patients hadⅢdegree radiation esophagitis.Conclusion The treatment modality of chemotherapy concurrent with SIB-IMRT in combination with nimotuzumab can improved the 5-year survival rate of patients with unresectable local-advanced esophageal cancer without considerably increasing side effects.