尼妥珠单抗与TPF的联合运用在头颈鳞癌中治疗效果的初步分析

Nimotuzumab combined with TPF chemotherapy in head and neck squamous cell carcinoma:A preliminary analysis

目的 评估尼妥珠单抗联合TPF化疗对比TPF化疗对头颈部鳞状细胞癌患者的疗效是否差异,并初步探讨两种方案相互作用的分子机制。方法 本研究为回顾性研究。收集了62例(2016—2021年)在江苏省口腔医院口腔颌面外科病房进行治疗的Ⅲ~ⅣA期头颈鳞状细胞癌患者,其中30例接受TPF化疗方案前接受300 mg尼妥珠单抗静脉滴注,为A组;其余32例为B组,仅接受TPF治疗。此外取B组进行诱导化疗的部分患者化疗前后的组织蜡块,进行免疫组织化学染色,观察EGFR表达量变化。结果 A组和B组的肿瘤有效缓解率分别为78%和43%,两者差异有统计学意义(P<0.05)。A组和B组的5年总生存率分别为72.2%和36.6%,两组差异有统计学意义(P<0.05)。A组和B组的5年无进展生存率分别为63.8%和36.2%。A组的5年无进展生存率与B组差异有统计学意义(P<0.05)。免疫组化染色显示相较B组和单用尼妥珠单抗,A组化疗后EGFR表达量下降更为显著。结论 头颈部鳞状细胞癌患者,接受尼妥珠单抗联合TPF化疗比单纯TPF化疗有更好的疗效。尼妥珠单抗靶向治疗与TPF化疗方案间存在一定的协同作用。

Objective To investigate the difference between the efficacy of Nimotuzumab combined with TPF chemotherapy and TPF chemotherapy alone in patients with squamous cell carcinoma of the head and neck,and to briefly discuss the molecular mechanism of interaction between Nimotuzumaband TPF chemotherapy.Methods This study retrospectively collected 62 patients with stage II-IV A head and neck squamous cell carcinoma in the Stomatological Hospital of Jiangsu Province from 2016 to 2021.Everyone engaged ac-cepted TPF chemotherapy.Thirty patients were given 300 mg dose of Nimotuzumab before the TPF therapy,classified as group A.The rest 32 patients were classified as group B.Tissue wax blocks before and after surgery of patients receiving induction chemotherapy in group B were collected for immunohistochemical staining to observe the expression of ECFR.Results After chemotherapy,the re-sponse rate of tumor in group A was 78%,and that in group B was 43%.There was statistically significant difference between the two groups(P<0.05).The five-year overall survival rate of group A and group B was 72.2%and 36.6%,respectively,with statistically sig-nificant difference(P<0.05).The progression-free survival rates of group A and group B were 63.8%and 36.2%,respectively.The difference was statistically significant(P<0.05).Immunohistochemical staining showed that the expression of EGFR in group A de-creased more significantly than that in group B or Nimotuzumab alone.Conclusion In patients with II-IVA squamous cell carcinoma of the head and neck,Nimutuzumab combined with TPF chemotherapy provides patients with better efficacy compared with TPF chemo-therapy alone.There is probably a synergistic effect between Nimutuzumab and TPF chemotherapy.