基于VMAT放疗技术联合化疗加用尼妥珠单抗治疗EGFR表达阳性的Ⅳa期鼻咽癌的临床研究

Clinical study on VMAT + chemotherapy + nimotuzumab for stage-Ⅳa nasopharyngeal carcinoma with positive EGFR

目的 探究表皮生长因子受体(EGFR)表达阳性的Ⅳa期鼻咽癌患者采用容积调强放射治疗(VMAT)放疗技术联合化疗加用尼妥珠单抗治疗的临床效果。方法 选择2021年4—11月高州市人民医院收治的80例鼻咽癌患者为研究对象,均为EGFR表达阳性的Ⅳa期患者。根据治疗方案分为两组,对照组VMAT放疗+化疗,试验组VMAT放疗+化疗+尼妥珠单抗,每组各40例。比较两组鼻咽癌客观缓解率(ORR)、完全缓解率(CR)、无进展生存期(PFS)、肿瘤学指标、毒副反应。结果 试验组ORR显著高于对照组,差异有统计学意义(P<0.05)。试验组CR高于对照组,但差异无统计学意义(P>0.05)。试验组PFS较对照组长,差异有统计学意义(P<0.05)。治疗前,两组EB病毒(EBV)DNA定量比较,差异无统计学意义(P>0.05)。治疗后两组EBV DNA定量较治疗前低,且试验组低于对照组,差异有统计学意义(P<0.05)。试验组毒副反应总发生率与对照组比较,差异无统计学意义(P>0.05)。结论 基于VMAT放疗技术联合化疗加用尼妥珠单抗治疗的方案用于EGFR表达阳性的Ⅳa期鼻咽癌患者临床治疗,疗效确切,值得推广使用。

Objective To investigate the clinical efficacy of treatment with volumetric modulated arc therapy(VMAT) + chemotherapy + nimotuzumab in patients with stage-Ⅳ a nasopharyngeal carcinoma harboring positive epidermal growth factor receptor(EGFR). Methods A total of 80 patients with stage-Ⅳ a nasopharyngeal carcinoma harboring positive EGFR admitted to the People’s Hospital of Gaozhou from April to November 2021 were selected as the study subjects. They were divided into the control group(VMAT + chemotherapy) and the experimental group(VMAT + chemotherapy + nimotuzumab), with 40 patients in each group. The objective response rate(ORR), complete response rate(CR), progression-free survival(PFS), oncological indicators, and toxic and side effects of nasopharyngeal carcinoma were compared between the two groups. Results The ORR of the experimental group was significantly higher than that of the control group, with statistically significant difference(P< 0.05). The CR of the experimental group was higher than that of the control group, but with no statistically significant difference(P > 0.05). PFS in the experimental group was longer than that in the control group, with statistically significant difference(P< 0.05). Before treatment, there was no statistically significant difference between the two groups in the quantification of DNA of Epstein-Barr virus(EBV)(P > 0.05). After treatment, the quantification of DNA of EBV in the two groups was lower than that before treatment, and that in the experimental group was lower than that in the control group, with statistically significant difference(P< 0.05). There was no statistically significant difference between the two groups in the incidence of toxic and side effects(P > 0.05). Conclusion The regimen of VMAT + chemotherapy + nimotuzumab for the clinical treatment of patients with stage-Ⅳ a nasopharyngeal carcinoma harboring positive EGFR is definitely effective and is worthy of promotion and application.