Department of Oncology, The Second Affiliated Hospital of SUN YAT-SEN University, Guangzhou, China.
Oral Oncol. 2011 Aug;47(8):753-7. doi: 10.1016/j.oraloncology.2011.06.002. Epub 2011 Jun 25.
We evaluated the incidence of acute toxicity of concurrent cyclooxygenase-2 inhibitor (celecoxib) plus radiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma (NPC). Thirty-four patients received an accumulated radiation dose of 72-76Gy in 36-38 fractions to the primary lesion and 60Gy in 30 fractions to cervical lymph-node lesions. Palpable residual nodes were boosted to 70Gy at the 90% isodose level with an electron field. Celecoxib was administered at escalating doses of 400, 600, and 800mg/day, starting 3days before the first fraction of radiotherapy and continuing throughout the course of radiotherapy. The majority of toxicities were grade 1, with mucositis and weight loss most frequently observed (28 of 34, 82.4%), followed by dermatitis (27 of 34, 79.4%) and otitis (14 of 34, 41.2%). The toxicities were not related to celecoxib dose (all P>0.05). Stomach pain was considered related to celecoxib, which developed in 2 patients at doses of 400mg and 800mg/day. No grade-3 or -4 toxicities or episodes of toxic death occurred. The tumors in 31 patients (31/34, 91.2%) showed a complete response, and 3 patients (3/34, 8.8%) had partial responses. The actuarial local progression-free survival was 96.6% at 1year, and the 2year overall survival rate was 84.6%. Celecoxib can be safely administered concurrently with nasopharyngeal radiotherapy at doses up to 800mg/day. The tumors responded well to treatment warranting further assessment in a phase II trial.
我们评估了同期环氧化酶-2 抑制剂（塞来昔布）联合放疗治疗局部晚期鼻咽癌（NPC）患者急性毒性的发生率。34 例患者接受了原发灶 72-76Gy/36-38 次和颈部淋巴结病变 60Gy/30 次的累积剂量照射。触诊到的残留淋巴结用电子野在 90%等剂量线水平加量至 70Gy。塞来昔布从放疗第一天前 3 天开始，以 400、600 和 800mg/天的递增剂量给药，一直持续到放疗结束。大多数毒性为 1 级，最常见的是粘膜炎和体重减轻（34 例中有 28 例，82.4%），其次是皮炎（34 例中有 27 例，79.4%）和耳炎（34 例中有 14 例，41.2%）。毒性与塞来昔布剂量无关（均 P>0.05）。2 例患者（剂量为 400mg 和 800mg/天）出现了胃痛，被认为与塞来昔布有关。没有发生 3 级或 4 级毒性或毒性死亡事件。31 例患者（31/34，91.2%）的肿瘤完全缓解，3 例患者（3/34，8.8%）部分缓解。1 年时局部无进展生存率的累积为 96.6%，2 年总生存率为 84.6%。塞来昔布可在每天高达 800mg 的剂量下与鼻咽放疗同时安全给药。肿瘤对治疗反应良好，值得在 II 期试验中进一步评估。
